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THE    UNIVERSITY    OF    PENNSYLVANIA 


THE   OPENING 


OF 


THE   NEW  BUILDING 


OF  THE 


HENRY   PHIPPS   INSTITUTE 


Columbia  ^nibersJitp 
CoUege  of  S^hv^icims  anb  burgeons! 


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HENRY    PHIPPS 


THE    UNIVERSITY    OF    PENNSYLVANIA 


AN  ACCOUNT 

OF  THE 

EXERCISES  ON  THE  OCCASION 

OF  THE 

OPENING  OF  THE  NEW  BUILDING 

OF  THE 

HENRY    PHIPPS    INSTITUTE 


Seventh  and  Lombard  Streets,  Philadelphia 
May  lo,  1913 


INTRODUCTION 


For  ten  years  after  its  organization  on  February  i,  1903,  the 
work  of  the  Henry  Phipps  Institute  was  carried  on  in  two  re- 
modeled dwellings  at  Nos.  236-238  Pine  St.  In  1907  Mr.  Phipps 
acquired  a  number  of  small  properties  at  the  northeast  corner  of 
Seventh  and  Lombard  Streets,  extending  north  to  Addison, 
as  a  site  for  a  permanent  building. 

The  architect,  Mr.  Grosvenor  Atterbury,  of  New  York,  made 
preliminary  studies  of  the  building,  and  the  plans  were  exhibited 
at  the  Congress  on  Tuberculosis  in  1908.  In  the  year  following 
the  Institute  was  placed  in  charge  of  the  trustees  of  the  University 
of  Pennsylvania,  the  arrangement  taking  efTect  July  i,  1910. 
The  study  of  building  plans,  which  had  been  dropped  during  the 
period  of  transition,  was  resumed  with  vigor;  a  year  later  ground 
was  broken,  and  the  work  of  erection  was  begun.  On  March  i, 
1 913,  the  laboratory  wing  was  occupied,  and  by  May  i  all  the 
work  of  the  Institute  was  housed  in  the  new  building. 

The  exercises  marking  the  opening  were  held  Saturday,  May 
10.  In  the  afternoon,  at  a  meeting  of  the  trustees  of  the  Univer- 
sity of  Pennsylvania  and  in  the  presence  of  a  distinguished  as- 
semblage, including  visitors  from  many  States,  degrees  were  con- 
ferred upon  Mr.  Henry  Phipps  and  Dr.  Edward  L.  Trudeau; 
addresses  were  made  by  the  Provost  of  the  University,  Edgar 
F.  Smith,  Dr.  Lawrence  F.  Flick,  and  Dr.  Herman  M.  Biggs. 
In  the  evening  a  dinner  was  given  at  the  Hotel  Bellevue-Stratford, 
at  which  the  speakers  were  Mayor  Rudolph  Blankenburg,  Dr. 
S.  Weir  Mitchell,  Dr.  William  H.  Welch,  Dr.  Theobald  Smith  and 
Dr.  Alfred  Stengel.  The  speeches  on  both  occasions  are  embodied 
in  this  volume. 


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THE  NEW  BUILDING  OF  THE 
HENRY  PHIPPS  INSTITUTE 
FROM   THE    SOUTHWEST 


WAITING  ROOMS  FOR  MEN  AND 
WOMEN  ON  THE  MAIN  FLOOR,  WITH 
CLINICAL  LABORATORY  AND  LARYNGO- 
LOGICAL  CLINIC  AT  END  OF  CORRIDOR 


PORCH  AND  OPEN  DECK  ADJOIN- 
ING WARDS  FOR  ADVANCED 
CASES  ON  THE   THIRD    FLOOR 


KIOSK  AND  OPEN  DECK  AD- 
JOINING WARDS  FOR  EARLY 
CASES  ON  THE  FOURTH  FLOOR 


SOLARIUM  ON  THE  FIFTH  FLOOR 


OPENING  EXERCISES 


Dr.  Edgar  F.  Smith,  Provost  of  the  University  of  Pennsyl- 
vania, presided. 


The  Provost: 

The  Rev.  Dr.  Floyd  W.  Tomkins  will  now  invoke  the  blessing 
of  Almighty  God  upon  the  exercises  of  this  hour. 

Dr.  Tomkins: 

Let  us  pray.  O  Lord  our  God,  unto  Thee  we  come,  for  in 
Thy  name  we  would  do  all  things  and  upon  all  that  we  do 
we  ask  Thy  blessing.  We  are  Thy  children  and,  we  beseech 
Thee,  bless  all  of  our  undertakings.  We  thank  Thee  O  Lord 
that  Thou  hast  put  it  in  the  heart  of  Thy  servant  to  erect 
this  building  for  the  saving  of  the  bodies  of  men  from  suffering 
and  sickness.  Send  Thy  blessing  upon  it,  we  beseech  Thee,  and 
the  work  it  is  to  do.  Bless  the  physicians,  bless  the  patients, 
bless  those  who  have  made  this  building  possible.  Send  Thy 
blessing  upon  those  broad-minded,  far-seeing  men  and  women 
who  desire  to  fulfil  the  Divine  obHgation  and  bring  Thy  Kingdom 
to  earth  by  saving  the  bodies  of  men  and  so  making  easier  the 
salvation  of  their  souls.  Grant,  we  beseech  Thee,  that  all  things 
undertaken  in  Thy  name  and  for  Thy  sake  may  come  to  such 
success  as  Thou  seest  best.  Send  Thy  blessing  upon  the  exercises 
of  this  hour,  that  we  may  be  filled  with  new  courage  and  hope 
through  the  words  spoken  on  this  occasion.  We  ask  these  bless- 
ings in  the  name  of  Him  who  taught  us  to  say:  Our  Father  who 
art  in  Heaven,  hallowed  be  Thy  name.  Thy  Kingdom  come. 
Thy  will  be  done  on  earth  as  it  is  in  Heaven.    Give  us  this  day 

17 


our  daily  bread  and  forgive  us  our  trespasses  as  we  forgive  those 
who  trespass  against  us,  and  lead  us  not  into  temptation  but  de- 
liver us  from  evil,  for  Thine  is  the  Kingdom  and  the  power  and 
the  glory  for  ever  and  ever,  Amen. 

The  Provost: 

"Medicine  is  my  wife;  science  is  my  mistress;  books  are 
my  companions;  my  study  is  my  grave;  there  I  lie  buried, 
the  world  forgetting,  by  the  world  forgot."  Thus  spake  Ben- 
jamin Rush,  and  I  wonder  and  have  been  wondering  since 
entering  this  building,  after  hearing  the  remarks  of  my  associates 
upon  all  sides,  just  what  that  grand  old  physician  would  say  could 
he  sit  with  us  this  moment.  Surely  he  would  promptly  recognize 
that  he  was  not  by  the  world  forgot  and  that  the  dread  disease 
from  which  he  suffered  from  his  eighteenth  until  his  forty-fifth 
year  had  been  receiving  untold  attention  in  the  century  which 
has  just  passed,  since  his  departure  to  that  bourn  whence  no 
traveller  returns.  As  I  recall  it.  Dr.  Rush  maintained  that  the 
only  cure  for  consumption  would  be  found  in  remedies  which  act 
upon  the  whole  system.  He  thought  that  the  symptoms  of  its 
early  stage  should  be  most  carefully  studied,  not  only  by  physi- 
cians, but  by  parents  and  by  friends,  and  maintained  that  the 
remedies  for  the  early  stage  were  extremely  simple,  such  as  de- 
sertion of  sedentary  employments,  the  quitting  of  damp  or  cold 
situations,  the  seeking  out  of  dry  places,  reveling  in  country  air 
distant  from  the  sea, — the  higher  and  drier  the  place,  so  much  the 
better, — and  then  he  recommended  change  in  climate.  The  re- 
turn of  the  complaint,  he  wrote,  might  be  prevented  by  exercise, 
depending  upon  the  state  of  the  disease  and  the  strength  of  the 
patient.  Observations  of  all  these  points,  we  are  to  believe, 
effected  his  own  cure  more  than  one  hundred  years  ago,  but  what 
inroads  and  terrible  ravages  the  disease  has  made  and  committed 
since  the  days  of  Rush,  one  hundred  years  ago !  For  we  learn  that 
now  200,000  persons  die  annually  in  the  United  States  from  open 
ulcerated  tuberculosis;  hence  it  is  not  surprising  that  the  most 
brilliant  medical  talent  has  devoted  itself  to  the  experimental 


study  of  the  disease  in  its  many  forms.  Grateful  should  we  be 
for  the  efforts  of  these  saviors  of  perishing  humanity.  Grateful 
and  proud  should  we  be  that  in  our  own  commonwealth  the  most 
patient  and  at  the  same  time  the  most  strenuous  and  persistent 
endeavors  have  been  put  forth  by  noble  heroic  souls  in  the  mighty 
struggle  to  win  out  against  this  insidious  foe,  and  most  thankful 
should  we  be  for  those  grand  benefactors  who,  Hke  Mr.  Henry 
Phipps,  in  the  overflowing  love  of  their  great  hearts,  create 
foundations  properly  equipped  with  means  for  the  care  and  the 
cure  of  the  sadly  afflicted  ones.  The  University  of  Pennsylvania, 
keenly  alive  to  the  significance  and  deeply  appreciative  of  Mr. 
Phipps'  unique  foundation,  including  this  wonderful  Institute, 
bids  me  here  publicly  express  to  him  its  most  sincere  thanks  for 
the  gift,  a  gift  which  in  itseK  proclaims  him  before  the  whole 
civilized,  applauding  world,  to  be  indeed  my  brother's  keeper. 

The  Secretary  of  the  University: 
Candidates  for  degrees  will  now  be  presented: 
Edward  L.  Trudeau,  Doctor  of  Laws. 

The  Provost: 

Edward  Livingstone  Trudeau,  founder  of  the  first  sanita- 
rium for  the  treatment  of  incipient  consumption  in  working- 
men  and  women,  founder  of  the  first  research  laboratory  in 
the  United  States  for  the  experimental  study  of  tuberculosis — 
director  today  of  these  two  institutions — active,  earnest,  esteemed 
author — beloved  physician,  pioneer  veteran  in  a  sacred  cause — 
fondly  thought  of  as  one  of  our  own,  we  write  thy  name  upon 
these  waUs,  and  I,  the  Provost  of  the  University  of  Permsylvania, 
by  virtue  of  the  authority  committed  to  me  by  the  mandamus  of 
its  trustees,  confer  upon  you  the  honorary  degree  of  Doctor  of 
Laws,  admitting  you  to  aU  the  rights  and  privileges  which, 
throughout  the  world,  pertain  to  this  degree.  In  testimony 
whereof  I  now  present  this  diploma,  signed  by  the  Provost  and 
Vice-Provost  and  confirmed  by  the  corporate  seal  of  the  Uni- 
versity of  Pennsylvania. 

19 


The  Secretary  of  the  University: 
Henry  Phipps,  Doctor  of  Laws. 

The  Provost: 

Henry  Phipps,  ironmaster,  man  of  affairs,  philanthropist — 
unswervingly  devoted  to  the  amelioration  of  disease-stricken 
himianity,  with  a  sympathetic  zeal  and  ardor  which  have  won 
the  approbation  of  the  wise  and  good  the  world  over  I  Who 
heals  the  body  can  best  heal  the  heart,  and  I,  the  Provost 
of  the  University  of  Pennsylvania,  by  virtue  of  the  authority 
committed  to  me  by  the  mandamus  of  its  trustees,  confer  upon 
you  the  honorary  degree  of  Doctor  of  Laws,  admitting  you  to  all 
the  rights  and  privileges  which,  throughout  the  world,  pertain 
to  this  degree.  In  testimony  whereof  I  now  present  this  diploma, 
signed  by  the  Provost  and  Vice-Provost  and  confirmed  by  the 
corporate  seal  of  the  University  of  Pennsylvania. 

I  am  further  charged  by  all  interested  in  this  Institute,  to 
express  to  the  architects,  represented  by  Mr.  Atterbury,  our 
very  sincere  thanks. 

And  now  permit  me  to  present  to  you  one  who  is  famiHar  with 
the  work  of  the  Phipps  Institute  from  the  day  of  its  birth.  Dr. 
Lawrence  F.  Flick. 


20 


AN  HISTORICAL  SKETCH  OF  THE  HENRY 
PHIPPS  INSTITUTE 

Dr.  Lawrence  F.  Flick 


The  opening  of  the  permanent  abode  of  the  Henry  Phipps 
Institute  is  perhaps  a  fitting  occasion  for  putting  on  record  its 
inception  and  early  history  and  its  work  during  its  years  of  pro- 
bation. Its  years  of  probation  may  be  said  to  be  from  the  time 
of  its  inauguration  to  the  time  when  its  permanency  was  definitely 
determined  upon  and  it  was  handed  over  to  the  University  of 
Pennsylvania.  The  beginning  and  end  of  this  period  are  Febru- 
ary I,  1903,  and  January  i,  1910. 

The  Institute  had  its  inception  in  the  contact  of  two  impulsive 
men,  one  a  physician  who  in  the  behef  that  tuberculosis  could  be 
wiped  out  worked  himself  up  into  a  high  state  of  enthusiasm,  and 
the  other  a  retired  business  man  who  had  made  money  and  was 
burning  with  a  desire  to  spend  it  in  the  interest  of  humanity. 
On  October  23, 1902,  Mr.  Henry  Phipps  wrote  me:  "I  am  waiting 
with  interest  to  hear  further  about  the  little  clinic  in  the  smaU 
house  I  am  to  buy  for  the  purpose  you  explained  when  I  saw  you. 
Mr.  Gordon  will  go  over  to  Philadelphia  to  look  at  the  premises 
and  can  arrange  with  the  Title  Insurance  Company  to  attend  to 
the  matter  of  proper  transfer  and  he  wiU  pay  the  Company  the 
check  when  you  advise  me  the  proper  amount.  What  alterations 
and  improvements,  painting,  etc.,  would  be  necessary  to  properly 
fit  the  building  for  the  purpose  intended?"  The  houses  here 
referred  to,  for  there  were  really  two,  were  small  buildings  at  No. 
719  and  No.  721  Lombard  Street,  which  I  had  hoped  to  be  able  to 
rent  and  where  I  had  prospects  of  opening  a  httle  clinic  on  a  capital 
of  $1000  which  some  kind  lady  had  offered  me. 

21 


On  October  25th,  instead  of  sending  Mr.  Gordon,  Mr.  Phipps 
came  himself  to  talk  over  the  Httle  clinic  with  me.  After  dis- 
cussing the  subject  for  a  while  in  my  sitting-room  at  No.  736  Pine 
Street,  he  became  so  enthused  that  he  said:  "Doctor,  go  out 
and  buy  the  block;  I'll  pay  for  it."  When  I  told  him  that  I 
might  not  be  able  to  pick  things  up  so  easily,  he  repHed:  "Do  not 
stand  too  much  on  prices,  but  buy.  We  want  to  do  this  work; 
get  the  property  and  we  will  talk  things  over  on  the  way  to 
Europe." 

Of  course,  I  was  not  able  to  buy  the  block  and,  greatly  to  my 
chagrin,  I  was  not  even  able  to  rent  the  houses  of  which  I  felt  so 
sure;  for  when  the  people  found  that  I  really  wanted  them,  they 
refused  to  let  me  have  them.  I  went  to  Europe  with  Mr.  Phipps, 
however,  a;nd  we  talked  things  over.  Before  going,  I  employed 
a  real  estate  agent  to  get  us  either  that  block  or  some  other  block 
during  my  absence. 

Mr.  Phipps  before  leaving  for  Europe  set  aside  enough  money 
to  finance  the  new  institution  during  his  absence,  as  he  himself 
was  starting  upon  a  trip  around  the  world  to  be  gone  for  a  year. 
We  sailed  on  November  4th  and  I  returned  home  on  December 
23d  after  inspecting  various  institutions  in  Europe.  When  I 
got  back,  my  agent  had  not  been  able  to  buy  even  a  foot  of 
ground. 

He  had,  however,  found  an  empty  building  at  No.  238  Pine 
Street  which  had  been  without  a  tenant  for  years  and  could  be 
rented.  Unfortunately,  another  obstacle  loomed  up,  for  there 
was  a  law  upon  the  statute  books  of  Pennsylvania  which  pro- 
hibited the  estabUshment  of  hospitals  in  the  built-up  portions  of 
the  city.  The  legislature  was  in  session  and  when  appealed  to 
removed  this  obstacle  by  promptly  and  unanimously  repealing  the 
law.  The  house  was  rented  and  before  any  other  obstacles  could 
be  placed  in  our  way  was  open  for  work.  The  Institute  began  its 
career  on  February  ist  in  this  building  with  a  few  chairs  and  a 
good  many  patients.  The  publicity  which  the  newspapers  had 
given  the  undertaking  brought  patients  from  every  quarter,  so 
that  it  was  difficult  to  meet  the  demands  for  help  and  treatment. 

22 


With  Mr.  Phipps'  liberal  backing,  however,  all  difficulties  were 
promptly  overcome,  and  in  a  relatively  short  time  the  old  building 
was  equipped  with  fifty-two  beds,  a  small  laboratory,  and  facilities 
for  running  a  large  dispensary.  An  earnest,  zealous  staff  of  well- 
trained  young  men  was  soon  organized  and  worked  with  zeal 
and  enthusiasm. 

When  Mr.  Phipps  returned  from  his  trip  around  the  world, 
he  found  a  well-established  institute  operating  along  the  lines 
which  had  been  forecast  in  our  discussions.  The  fifty  thousand 
dollars  which  he  had  left  to  begin  the  work  with  had  been  used 
up.  He  was  well  pleased  and  promptly  set  aside  a  much  larger 
sum  to  be  drawn  against  in  amounts  of  fifty  thousand  dollars  a 
year.  "When  this  amount  is  exhausted,  I  will  give  more,"  were 
his  encouraging  words. 

The  purposes  and  objects  of  the  Institute  as  determined  by 
Mr.  Phipps  and  myself  on  our  trip  to  Europe  were  announced  in 
the  Philadelphia  Medical  Journal  of  January  21,  1903,  immedi- 
ately upon  my  return  in  the  following  words :  "  The  Henry  Phipps 
Institute  for  the  Study,  Treatment  and  Prevention  of  Tubercu- 
losis is  to  be  an  institution  devoted  exclusively  to  the  work  of  ex- 
terminating tuberculosis.  Prevention  will  be  the  ultimate  object 
of  everything  that  is  done  in  the  institution  and  the  establishment 
will  be  planned  and  operated  with  that  aim  foremost  in  mind. 
The  Institute  will  consist  of  pavilions  with  a  cap'acity  of  one 
hundred  beds,  well-equipped  laboratories,  facihties  for  hydro- 
therapeutic  and  phototherapeutic  work  and  of  such  other  acces- 
sories as  may  be  necessary  for  carrying  out  the  plans  of  the 
Institute.  There  will  be  a  dispensary  connected  with  the  Insti- 
tute from  which  will  be  given  treatment  and  aid  to  the  consump- 
tive poor  who  are  unable  to  give  up  employment  or  who  cannot 
gain  admission  into  some  institution.  The  pavilions  will  be 
built  with  balconies  and  a  roof-garden  so  that  the  patients  can 
be  kept  in  the  open  air  as  much  as  possible.  The  wards  and 
balconies  will  be  so  constructed  that  every  bed  can  be  run  out  on 
a  balcony  and  the  patient  kept  in  the  open  air  day  and  night  if 
necessary.    The  beds  of  the  Institute  will  be  used  exclusively  for 

23 


advanced  cases,  the  object  being  to  take  these  patients  out  of 
their  homes  and  thus  prevent  the  spread  of  the  disease.  The 
house  patients  will  furnish  the  clinical  material  for  scientific  re- 
search in  the  laboratories  and  in  the  various  departments  which 
will  be  attached  to  the  Institute.  Facilities  will  be  given  for 
testing  all  new  ideas  in  the  treatment  of  tuberculosis  which  have 
a  scientific  basis.  .  .  .  Patients  will  be  treated  both  at  the 
dispensary  and  when  too  far  advanced  to  corqe  to  the  dispensary 
at  their  homes.  Medicine  and  food  will  be  supplied  when  neces- 
sary, as  also  disinfectants,  spit-cups,  and  paper  napkins.  They 
will  be  taught  the  use  of  these  things  and  they  will  be  kept  under 
supervision  so  as  to  insure  the  carrying  out  of  proper  preventive 
measures.  Printed  instructions  will  be  furnished  them  as  to  what 
to  do  in  order  to  prevent  the  spread  of  the  disease  and  an  effort 
will  be  made  to  enforce  the  rules  which  are  laid  down.  A  Hterary 
bureau  will  be  established  in  the  Institute.  .  .  .  An  effort 
to  stimulate  activity  in  the  crusade  against  tuberculosis  will  be 
made  through  this  bureau  and  aid  will  be  extended  in  efforts  at 
organization  wherever  such  aid  is  called  for.  .  .  .  The  hold- 
ing of  conferences  and  congresses  on  the  subject  of  tuberculosis 
for  the  purpose  of  stimulating  thought  and  action  will  be  encour- 
aged and  patronized.  .  .  .  With  a  view  of  bringing  clinical 
and  laboratory  work  as  close  together  as  possible  only  men  will 
be  appointed  to  the  staff  who  are  equipped  for  both  clinical  and 
laboratory  work."  As  this  program  indicates,  the  Institute 
started  out  to  set  the  world  aflame  with  a  burning  zeal  to  stamp 
out  tuberculosis. 

After  Mr.  Phipps  had  had  time  to  think  over  what  had  been 
done  during  the  first  year  and  to  talk  it  over  with  some  of  his 
friends,  he  was  somewhat  shaken  in  his  purpose  of  going  on  with 
the  work  laid  down  and  again  thought  of  taking  up  the  sana- 
torium work,  which  had  been  his  original  purpose.  To  him,  as  to 
most  people,  a  house  full  of  dying  consumptives  with  a  lot  of 
enthusiastic  medical  men  trying  to  extract  a  boon  for  humanity 
out  of  them  was  a  melancholy  sight  not  well  calculated  to  pull 
fifty  thousand  dollars  a  year  out  of  one's  pocket.    He  wrote 

24 


from  Europe  that  he  would  like  us  to  find  a  site  for  a  sanatorium 
so  that  he  might  devote  at  least  a  part  of  the  money  to  sanatorium 
work.  We  looked  for  such  a  site  and  had  a  number  of  favorable 
locations  in  view  for  his  inspection  on  his  return.  After  going 
over  the  entire  subject  with  me  again,  however,  and  hearing  what 
was  to  be  said  on  the  side  of  caring  for  dying  cases  and  using  ma- 
terial which  was  available  in  this  way  for  elucidating  the  subject 
of  tuberculosis,  he  said:  "We  will  go  on,  for  this  seems  to  be  the 
better  work."  We  abandoned  the  idea  of  establishing  a  sana- 
torium, and  he  commissioned  me  to  persevere  in  my  efforts  to 
secure  a  site  for  the  permanent  home  of  the  Institute. 

The  task  of  finding  a  site  for  a  permanent  home  proved  to  be 
a  difficult  one;  not  only  because  people  objected  to  the  location 
of  the  Institute  near  them,  but  also  because  conscienceless  specu- 
lators when  they  got  even  a  suspicion  that  a  wealthy  man  was 
looking  for  ground  upon  which  to  establish  an  institution  in  the 
interest  of  humanity  put  up  their  price  to  a  forbidding  figure. 
Besides,  in  the  old  part  of  the  city  where  it  was  desirable  to  locate, 
titles  to  property  were  sometimes  much  involved.  For  these 
reasons,  it  took  seven  years  of  painful  effort  and  much  chagrin 
and  annoyance  to  get  the  ground  upon  which  the  present  building 
stands  and  even  for  some  of  it  exorbitant  prices  had  to  be  paid. 
A  number  of  sites  were  looked  at  during  that  time  and  options 
were  taken  on  some  of  them,  but  in  the  end  the  ground  upon 
which  this  building  stands  was  selected  and  we  found  ourselves 
located  just  one  square  away  from  the  original  block  which  Mr. 
Phipps  had  directed  me  to  buy. 

Many  have  wondered  why  this  site  was  selected.  There  were 
two  impelling  reasons:  one  because  it  was  situated  in  the  slums 
where  an  institution  of  this  kind  is  needed,  and  the  other  because 
it  was  perhaps  the  most  degraded  spot  physically,  sanitarily, 
and  morally  in  the  city  of  Philadelphia.  Placing  the  Institute 
here  accomplished  a  twofold  purpose,  tearing  up  by  the  roots  a 
center  of  sin,  sorrow,  and  degradation  and  putting  in  its  place 
an  institution  consecrated  to  the  uplift  of  man.  For  nearly  a 
hundred  years,  at  least  beyond  the  memory  of  living  man,  this 

25 


place  reeked  with  human  depravity  too  foul  to  be  spoken  of  and 
extended  its  polluting  influence  in  every  direction  throughout  the 
city;  for  all  time  to  come  it  will  radiate  its  beneficent  influence 
not  only  throughout  the  city,  but  over  the  entire  world,  making 
men  good  by  making  them  healthy — the  noble  act  of  a  God- 
fearing man  making  perpetual  reparation  for  the  foul  deeds  done 
in  the  past.  For  this  alone  will  the  Recording  Angel  have  made 
a  record  for  Mr.  Phipps  in  the  Doomsday  Book  which  is  worth 
while. 

During  the  seven  years  of  my  stewardship  of  the  Phipps  Insti- 
tute, Mr.  Phipps  expended  upward  of  $350,000  in  the  work. 
What  has  the  world  gotten  out  of  his  generous  act?  Let  me  give 
a  brief  inventory  of  it. 

(a)  The  Institute  gave  the  world  a  new  idea  in  the  concentra- 
tion of  all  available  forces  for  the  accomplishment  of  a  single 
purpose  in  the  field  of  preventive  medicine.  It  is  the  first  organi- 
zation, so  far  as  my  knowledge  goes,  which  was  brought  into  exist- 
ence for  the  specific  purpose  of  studying  and  working  with  one 
disease  with  the  view  of  wiping  it  out.  It  introduced  into  pre- 
ventive medicine  a  rational  policy  and  accurate  business  methods. 
The  same  idea  has  since  been  put  into  operation  in  the  Koch 
Institute  in  Berlin,  the  Royal  Edward  Institute  of  Canada,  both 
devoted  to  tuberculosis;  the  Phipps  Psychiatric  Clinic  of  Balti- 
more, and  the  Institute  for  the  Study,  Treatment  and  Prevention 
of  Cancer  estabhshed  in  Liverpool,  England,  by  Mr.  McFadden 
of  Philadelphia. 

(b)  It  brought  to  the  United  States  the  International  Congress 
on  Tuberculosis.  Whilst  the  Institute  was  not  the  only  agent 
concerned  with  bringing  over  this  Congress,  without  the  Institute 
the  Congress  would  not  have  come  here.  In  March,  1902,  nearly 
a  year  before  the  Institute  was  organized,  I  tried  to  induce  the 
Marine  Hospital  Service  of  the  United  States  to  lead  a  movement 
for  bringing  over  the  International  Congress  on  Tuberculosis  but 
failed.  When  I  discussed  the  subject  with  Mr.  Phipps  on  our 
way  to  Europe,  he  told  me  to  take  whatever  preliminary  steps 
were  necessary  to  bring  over  the  Congress  and  that  he  would  stand 

26 


back  of  me  financially.  In  Berlin,  I  called  on  Dr.  Pannwitz, 
the  Secretary-general  of  the  International  Society  for  the  Study 
and  Prevention  of  Tuberculosis,  and  laid  my  project  with  its 
backing  before  him.  He  at  once  fell  in  with  the  undertaking  and 
from  that  time  on  gave  his  most  cordial  support  to  it.  At  the 
meeting  in  Paris,  in  1905,  it  was  tacitly  understood  that  the  Con- 
gress was  to  come  to  the  United  States  for  its  next  session,  and 
though  Japan  and  other  countries  offered  great  inducements  for 
the  holding  of  the  Congress  in  other  countries  the  invitation  from 
the  United  States  was  promptly  accepted. 

Not  only  did  the  Institute  play  the  chief  role  in  bringing  over 
the  Congress,  but  it  also  played  a  very  important  part  in  making 
it  a  success.  Three  members  of  the  staff  of  the  Institute  were  on 
the  delegation  to  Paris  that  invited  the  Congress,  and  five  mem- 
bers of  the  staff  held  important  positions  on  various  committees 
which  organized  the  Congress.  For  three  years  a  great  deal  of 
the  energy  of  the  staff  of  the  Institute  went  into  the  organization 
of  the  Congress  to  a  degree  indeed  that  prevented  the  Institute 
from  presenting  its  own  work  to  the  best  advantage  in  the  exhi- 
bition of  the  Congress.  Nevertheless,  it  took  two  gold  medals 
and  four  silver  medals  for  its  work. 

(c)  It  brought  the  seventh  session  of  the  International  Tu- 
berculosis Conference  to  the  United  States.  The  International 
Tuberculosis  Conference  is  made  up  of  workers  in  the  tuberculosis 
field  and  meets  annually.  During  the  year  in  which  the  Inter- 
national Congress  on  Tuberculosis  meets  it  is  customary  for 
the  International  Tuberculosis  Conference  to  convene  in  the 
country  in  which  the  Congress  convenes.  When  at  its  meet- 
ing in  Vienna  in  1907,  it  was  found  that  no  provision  had 
been  made  for  bringing  it  to  the  United  States,  I  cabled  the 
situation  to  Mr.  Phipps  and  he  promptly  cabled  back  that  I 
invite  the  Conference  to  Philadelphia  at  his  expense.  The  Con- 
ference came  here  as  the  guest  of  the  Henry  Phipps  Institute 
and  Mr.  Phipps  met  all  expenses,  including  the  cost  of  pubhcation 
of  the  transactions  over  and  above  what  was  contributed  by  the 
citizens  of  Philadelphia  and  the  city  of  Philadelphia  for  the  enter- 

27 


tainment  of  the  Conference.  The  meeting  of  the  Conference 
just  before  the  Congress  was  an  excellent  introduction  to  the 
Congress  itself  and  did  much  for  the  education  of  the  people  in 
tuberculosis  work  throughout  the  entire  country. 

(d)  It  brought  about  the  organization  of  the  National  Associa- 
tion for  the  Study  and  Prevention  of  Tuberculosis  of  the  United 
States.  Organized  leadership  of  tuberculosis  work  in  the  United 
States  had  fallen  into  questionable  hands  and  the  best  men  in  the 
country  kept  aloof  from  it.  The  necessity  of  reorganization  was 
apparent  to  every  one,  but  it  was  not  easy  to  find  a  plan  of  doing 
it.  The  Institute  made  the  reading  of  a  paper  prepared  by  Pro- 
fessor Maragliano,  of  Genoa,  Italy,  the  occasion  of  bringing  to- 
gether the  foremost  men  in  tuberculosis  work  in  the  United  States, 
and  after  the  paper  had  been  read  assembled  the  men  for  the 
purpose  of  organization.  Formal  organization  was  made  and 
an  adjournment  was  taken  to  meet  again  in  Atlantic  City  some 
time  subsequently  for  the  purpose  of  making  by-laws  and  electing 
officers.  The  organization  of  this  society  was  part  of  the  scheme 
of  the  Institute  for  bringing  over  the  International  Congress  on 
Tuberculosis,  since  the  existence  of  such  an  organization  was 
practically  a  condition  upon  which  the  Congress  would  come. 
The  Society  iromediately  took  its  position  with  international 
societies  of  other  countries,  and  has  since  been  the  successful 
leader  of  the  crusade  against  tuberculosis  in  the  United  States. 
It  is  at  present  perhaps  the  largest  and  strongest  organization 
of  its  kind  in  the  world. 

(e)  The  Institute  originated  and  developed  the  idea  of  making 
special  nurses  for  tuberculosis  work  out  of  girls  who  had  recovered 
from  tuberculosis.  When  the  Institute  was  opened,  it  was 
practically  impossible  to  secure  reliable  nurses  for  tuberculosis 
work  on  account  of  the  universal  fear  of  the  disease,  not  only  by 
the  laity  but  by  physicians  and  nurses.  In  its  dilemma,  the 
Institute  bethought  itself  of  using  cured  girls  from  White  Haven 
Sanatorium  for  ward-maids,  and,  finding  them  unusually  well 
fitted  to  minister  to  consumptives  by  the  sympathy  which  they 
felt  for  them,  hit  upon  the  thought  of  making  special  nurses  of 

28 


them.  From  the  very  beginning  the  scheme  was  successful  and 
proved  to  be  a  boon  to  the  crusade  against  tuberculosis.  The 
idea  has  been  taken  up  by  other  institutions  and  has  been  suc- 
cessfully carried  out  wherever  tried.  The  women  who  have 
thus  been  brought  into  the  practical  work  of  the  crusade  against 
tuberculosis  have  shown  themselves  not  only  to  be  good  nurses, 
but  zealous  missionaries  in  their  chosen  field. 

(f)  It  demonstrated  the  feasibility  and  practicability  of  treat- 
ing tuberculosis  successfully  anywhere  and  in  any  climate. 
American  physicians  had  in  recent  years  come  to  look  upon  tu- 
berculosis as  incurable  except  by  climatic  changes.  So  universally 
had  this  view  come  to  be  held  that  it  was  heresy  to  differ  from  it. 
The  fifty-two  beds  in  the  Institute  were  given  over  to  advanced 
cases,  but  it  was  found  that  many  of  these  advanced  cases  im- 
proved very  much  and  were  again  restored  to  a  life  of  usefulness. 
Most  of  the  members  of  the  staff  of  the  Institute  were  also  on  the 
White  Haven  staff  and  treated  cases  simultaneously  in  the  two 
institutions.  They  discovered  that  they  could  treat  severe 
cases  more  successfully  at  the  Phipps  Institute  than  at  White 
Haven  Sanatorium,  and  they  very  often  transferred  their  cases 
from  the  White  Haven  Sanatorium  to  the  Phipps  Institute.  In 
the  last  analysis,  strict  discipline  and  accurate  supervision  counted 
for  more  than  any  other  factors  and  where  these  could  be  best 
carried  out  the  best  results  were  obtained.  It  was  not  long  before 
every  member  of  the  staff  felt  confident  that  tuberculosis  could 
be  as  successfully  treated  in  the  slums  of  a  large  city  as  in  a  moun- 
tain resort.  The  experience  of  the  Institute  pubUshed  to  the 
world  through  its  reports  went  far  toward  convincing  the  scien- 
tific world  of  this  fact. 

(g)  It  inaugurated  the  social  service  work  in  the  crusade 
against  tuberculosis  in  the  United  States,  taking  for  its  model 
the  Emile  Roux  Dispensary  of  Lille,  estabhshed  and  directed  by 
Dr.  A.  Calmette.  It  sent  its  nurses  out  systematically  to  visit  its 
dispensary  patients  not  only  for  the  purpose  of  helping  them  to 
carry  out  the  treatment,  but  also  to  bring  about  improved  home 
conditions  and  show  other  members  of  the  family  how  to  avoid 

29 


contracting  the  disease.  It  systematically  distributed  preventive 
measure  supplies  to  the  families  which  it  supervised  and  gave 
milk  to  those  patients  who  could  not  buy  the  necessary  food. 
It  expended  on  an  average  about  ten  thousand  dollars  a  year  in 
this  kind  of  work.  Out  of  this  work,  it  demonstrated  the  limita- 
tion of  dispensary  and  social  service  work  as  a  factor  in  the  pre- 
vention of  tuberculosis  and,  in  consequence,  toward  the  end  of  the 
seven-year  term  lessened  its  expenditures  for  material  aid.  The 
world  has  come  to  recognize  that  for  the  prevention  of  tubercu- 
losis it  is  necessary  to  bring  under  control  and  close  supervision 
the  cases  passing  through  the  terminal  stage  of  the  disease. 

(h)  It  placed  tuberculosis  in  the  category  of  curable  diseases, 
worthy  of  the  attention  of  the  practising  physician.  By  carefully 
training  men  for  clinical  work  in  tuberculosis,  teaching  them 
accurate  methods  of  history  taking,  physical  examination  and 
treatment,  it  leavened  the  entire  medical  profession  through  the 
influence  of  these  men  until  all  practitioners  of  medicine  made  an 
earnest  effort  to  do  something  for  their  tuberculous  patients  to 
bring  about  recovery;  whereas  formerly  they  had  either  aban- 
doned them  to  a  hopeless  lot  with  the  advice  that  they  change 
climate,  or  had  soothed  them  with  ameliorating  treatment  to 
their  final  exodus.  The  history  sheets  which  were  so  carefully 
worked  out  by  the  staff  of  the  Phipps  Institute  have  been  used  as 
models  for  other  institutions  throughout  the  entire  country. 

The  scientific  work  of  the  Institute  during  the  seven  years 
has  been  in  part  published  in  five  volumes  of  records,  making  a 
total  of  about  twenty  thousand  octavo  pages.  Over  five  thousand 
cases  treated  in  the  hospital  and  dispensary,  of  which  more  than 
four  thousand  were  tuberculous  cases,  form  the  basis  of  this  work. 
Nearly  all  of  the  patients  who  died  in  the  hospital  were  studied 
pathologically  and  histologically.  Careful  statistics  on  the  clini- 
cal and  sociological  phases  of  tuberculosis  were  taken  in  all  of  the 
cases.  The  disease  was  studied  in  some  of  its  by-paths,  such  as 
those  which  lead  to  amentia,  insanity,  and  social  dependence. 
Not  only  were  the  most  complete  autopsies  made,  but  every  case 
was  carefully  analyzed  and  studied  in  its  clinical  relations  to  the 

30 


autopsy  findings.  Statistically,  the  five  volumes  of  reports  give 
the  most  reliable  and  noteworthy  data  upon  the  subject  of  tu- 
berculosis clinically,  sociologically,  and  pathologically  that  have 
ever  been  published. 

Some  of  the  important  problems  worked  out  by  the  Institute 
during  those  years  are :  (i)  The  elimination  of  tubercle  bacilli 
by  the  kidneys;  (2)  the  etiological  relationship  between  secondary 
infections  and  hemorrhages;  (3)  the  influence  of  tuberculosis  in 
the  production  of  nephritis;  (4)  the  relationship  between  tu- 
berculosis and  insanity;  (5)  the  extraordinary  part  which  tu- 
berculosis plays  in  the  production  of  social  dependence;  (6) 
the  danger  of  contagion  from  the  frequent  change  of  residence  of 
the  tuberculous  poor;  and  (7)  the  relationship  between  alcohol 
and  tuberculosis  and  tobacco  and  tuberculosis. 

On  November  i,  1909,  I  resigned  as  medical  director  and 
president  of  the  Institute  and  I  was  relieved  of  duty  on  the  ist 
of  January,  1910.  The  Institute  was  given  over  to  the  University 
of  Pennsylvania,  under  whose  management  it  has  been  since. 
This  step  was  taken  to  secure  permanency  for  the  Institute. 

How  well  the  Institute  has  succeeded  in  setting  the  world 
ablaze  with  zeal  for  the  extermination  of  tuberculosis  is  best 
shown  by  the  nineteen  million  dollars  expended  in  the  United 
States  during  the  year  1Q12  for  this  purpose.  The  whole  world 
is  now  in  arms  against  the  White  Plague,  and  the  fight  wiU  not 
lag  until  victory  has  been  won.  When  that  day  has  come  and  the 
history  of  the  combat  will  be  written,  the  name  of  Henry  Phipps 
will  be  one  of  the  most  conspicuous  in  the  book. 

The  Provost: 

Dr.  Herman  M.  Biggs,  of  New  York  City,  a  distinguished 
and  an  enthusiastic  member  of  our  Advisory  Council,  will  now 
address  you. 


31 


INDUSTRIAL  COLONIES  FOR  THE 
TUBERCULOUS 

Dr.  Hermann  M.  Biggs 


The  completion  of  the  buildings  of  the  Henry  Phipps  Institute 
for  the  study,  treatment,  and  prevention  of  tuberculosis,  and  their 
dedication  to  the  purposes  intended  by  their  generous  founder, 
constitute  an  event  full  of  significance  to  modern  work  in  pre- 
ventive medicine.  Ten  years  of  successful  work  of  the  Institute 
have  been  completed  and  the  buildings  opened  today  will  form  an 
important  landmark  in  the  progress  and  development  of  pre- 
ventive work,  in  the  most  important  period  in  its  history. 

It  is  difficult  even  for  those  who  have  been  entirely  conversant 
with  all  of  the  developments  in  medicine  during  the  last  thirty 
years,  and  who  have  taken  part,  in  some  measure,  in  these  de- 
velopments, to  gain  any  adequate  comprehension  of  their  full 
significance  and  bearing  on  the  industrial  progress  of  the  civilized 
world  and  on  the  reduction  in  the  rate  of  sickness  and  death  and 
the  consequent  improvement  in  the  general  welfare  of  the  race. 

The  preventive  work  in  tuberculosis  is  only  one  typical  phase 
of  the  preventive  work  which  has  been  going  steadily  on  in  many 
lines.  Mention  may  also  be  made  of  the  campaign  for  the  re- 
duction of  infant  mortality,  fbr  the  improvement  in  the  health 
and  the  prevention  of  disease  in  school  children,  for  the  prevention 
of  mental  disease,  for  the  prevention  of  ophthalmia  of  the  new- 
born and  of  blindness,  and  more  recently  of  the  movements  for 
the  prevention  of  venereal  disease,  of  cancer,  and  of  alcoholism. 
In  tropical  and  subtropical  countries,  too,  we  have  similar  activi- 
ties of  more  recent  date  looking  to  the  prevention  of  diseases 
peculiar  to  these  regions,  such  as  the  hookworm  disease,  the 

32 


sleeping  sickness,  the  malarial  fevers  and  yellow  fever,  tropical 
dysentery,  etc.  Because  of  its  early  inception,  its  popular 
character,  and  its  world-wide  extent,  the  tuberculosis  work  has 
attracted  more  attention  than  any  of  the  other  phases  of  this 
general  movement.  It  may  not  be  without  profit,  if  we  pause 
for  a  moment  and  look  back  over  the  accomplishments  of  the 
recent  past  and  try  to  measure  somewhat  their  value. 

During  the  past  fifty  years,  the  death  rates  in  the  great  cities 
of  the  world  have  been  reduced  fully  50%  and  the  mean  duration 
of  human  life  has  been  increased  by  more  than  25%.  In  some 
great  cities,  where  the  sanitary  conditions  were  formerly  extremely 
unfavorable  and  where  the  greatest  progress  has  been  made,  even 
more  than  this  has  been  accomplished.  It  may  be  safely  said 
that  at  least  ten  thousand  years  have  been  added  to  the  average 
duration  of  life  of  each  one  thousand  babies  born  in  many  of  the 
great  cities  of  the  world,  and  that  the  mean  lifetime  of  each 
individual  has  been  increased  from  less  than  forty  years  to  over 
fifty  years.  In  a  city  like  New  York  the  decrease  in  the  death- 
rate  means  a  saving  of  more  than  eighty  thousand  lives  a  year, 
and,  with  the  present  population  of  the  United  States,  if  the  death- 
rates  prevailing  before  the  Civil  War,  or  even  forty  years  ago, 
still  obtained,  a  million  additional  lives  would  be  sacrificed  each 
year  to  disease.  This  decrease  in  deaths  naturally  indicates  an 
enormous  decrease  in  the  amount  of  sickness. 

It  has  been  estimated  by  some  authorities  that  for  every  death 
taking  place  in  a  community,  twenty  cases  of  serious  illness  occur 
which  terminate  in  more  or  less  complete  recovery.  In  other 
words,  in  the  United  States  in  191 2  there  were  twenty  million 
less  instances  of  serious  illness  than  would  have  occurred  if  the 
conditions  existing  forty  years  ago  still  obtained.  It  is  not  easy 
to  gain  any  adequate  comprehension  of  the  economic  significance 
of  this  change.  It  would  be  difficult  to  estimate  the  value  of  the 
loss  in  time,  wages,  and  efficiency  and  the  cost  of  nursing,  medical 
attendance,  and  medicines,  which  such  illness  would  entail. 

It  is  not  necessary  before  this  audience  to  more  than  refer  to 
the  extraordinary  results  which  have  followed  the  scientific, 

33 


clinical  and  educational  work  of  numerous  organizations  through- 
out the  country  whose  purposes  are  similar,  in  part  at  least, 
to  those  of  the  Phipps  Institute,  nor  is  it  necessary  for  me  to 
consider  in  detail  the  character  or  scope  of  this  work. 

I  desire,  however,  to  refer  to  one  subject  of  fundamental 
importance  coimected  with  tuberculosis  which  has  recently  en- 
gaged the  time  and  interest  of  the  Directors  of  this  Institute, 
and  concerning  which  but  Httle  progress  has  been  made  anywhere. 
I  refer  to  the  provision  of  employment  for  patients  discharged 
from  tuberculosis  sanatoria  with  their  disease  arrested  or 
apparently  cured.  The  lack  of  suitable  occupations  under  proper 
conditions  for  such  patients  has  been  the  great  stumbling-block 
in  the  way  of  more  lasting  and  substantial  progress  in  the  efforts 
for  the  permanent  arrest  of  the  disease  especially  as  it  occurs  in 
the  working  class.  Experience  has  sho\vn  that  a  large  proportion 
of  the  cases  described,  when  they  return  to  the  conditions  and 
occupations  under  which  their  disease  originally  developed,  tend 
to  relapse  and  ultimately  die  of  the  disease. 

The  difficulties  in  the  provision  of  suitable  and  lucrative  occu- 
pations for  such  persons  in  a  favorable  environment  are  very  great 
and  have  not  been  satisfactorily  met  on  a  large  scale  anywhere  in 
the  world.  The  suggestion  must  at  once  come  to  every  one  that 
as  an  outdoor  life  is  especially  favorable  to  the  arrest  of  pulmonary 
tuberculosis,  outdoor  occupations,  such  as  farming,  gardening, 
horticulture,  etc.,  should  be  the  natural  occupations  of  choice 
for  persons  who  have  been  or  are  affected  with  the  disease.  In 
fact,  the  most  definite  and  systematic  attempts  to  provide  occu- 
pation for  these  persons  have  been  along  these  lines,  as,  for  ex- 
ample, the  Farm  Colony  of  the  Royal  Victoria  Hospital  in  Edin- 
burgh; but  experience  in  the  large  cities  in  this  country  has  shown 
that  a  very  large  percentage  of  the  cases  of  pulmonary  tubercu- 
losis come  from  the  indoor  workers  who  have  no  knowledge  of 
or  experience  in  such  occupations,  who  do  not  like  them,  and  who 
are  not  only  mentally  and  temperamentally  unfit  to  undertake 
them,  but  generally  have  not  the  physical  strength  and  endurance 
to  do  so. 

34 


It  is  well  known  that  in  arrested  or  apparently  cured  cases  of 
pulmonary  tuberculosis  physical  endurance  is  the  very  last  feature 
of  restored  health  to  return  and  the  one  which  often  enough  is 
never  regained.  On  the  other  hand,  these  individuals  are  usually 
quite  able  and  willing  to  undertake  less  laborious  occupations 
indoors  identical  with  or  similar  to  those  which  they  have  previ- 
ously followed. 

For  a  long  time  I  have  had  in  mind  the  estabHshment  of  in- 
dustrial colonies  in  the  country,  preferably  in  connection  with  the 
sanatoria,  where  the  climatic  conditions  are  favorable  for  tu- 
berculous patients,  where  land  is  cheap,  where  sanitary  workshops 
and  dwellings  can  be  erected,  and  where  the  workmen  can  spend 
the  unemployed  hours  of  the  day — at  least  twelve  or  fourteen 
hours — out-of-doors.  Dwellings  with  outside  sleeping  porches 
would  be  provided,  and  patient-employees  and  their  families 
would  be  kept  under  continued  supervision  as  to  all  of  the 
conditions  of  life,  including  their  food  and  dietary,  so  that 
the  most  favorable  conditions  would  surround  them  and  the 
earliest  indications  of  a  return  of  disease  would  be  immediately 
recognized.  Such  a  plan,  if  it  could  be  properly  carried  out, 
would,  in  my  judgment,  not  only  meet  the  humanitarian  de- 
mands, but  would  result  in  an  enormous  economic  saving  to  the 
community,  both  directly  and  indirectly,  and  would  become  a 
most  influential  factor  in  the  eradication  of  this  disease. 

Some  of  the  difficulties  in  carrying  such  a  plan  into  effect  are 
evident  enough:  The  difficulties  in  finding  suitable  and  lucra- 
tive occupations,  in  marketing  the  products  produced  by  tubercu- 
lous workers,  the  difficulty  in  finding  capital  to  establish  and 
maintain  such  colonies,  and  in  their  subsequent  conduct  and 
supervision.  I  feel  confident,  however,  that  these  difficulties 
can  be  and  will  be  overcome,  and  it  may  not  be  amiss  to  indicate 
briefly  the  immense  economic  gain  such  a  plan,  if  successfully 
carried  out,  would  afford. 

It  has  been  the  poHcy  at  the  New  York  Municipal  Sanatorium 
at  Otisville,  since  its  establishment,  seven  years  ago,  to  give  em- 
plo)anent  to  as  large  a  number  of  ex-patients  as  possible,  and  to 

35 


utilize  the  services  of  in-patients  during  their  treatment  in  the 
conduct  of  the  institution.  At  the  present  time,  with  over  five 
hundred  patients,  there  are  less  than  thirty  non-tuberculous 
employees  engaged  in  non-productive  occupations  in  connection 
with  the  institution.  We  have  over  one  hundred  tuberculous 
employees,  some  of  whom  have  been  engaged  for  a  number  of 
years  in  various  capacities.  Experience  there  has  shown  that  a 
large  percentage  of  the  discharged  patients  would  gladly  remain 
in  the  country  if  they  could  be  furnished  with  suitable  work. 
Further,  it  has  been  found  that  a  large  number  of  patients,  even 
many  of  those  well  advanced  in  the  second  stage  of  the  disease, 
are  able  to  do  nearly  a  full  day's  work  after  six  months  in  the  insti- 
tution, if  only  the  conditions  under  which  they  work  and  live  are 
satisfactory.  A  number  of  men  who  when  admitted  had  quite 
advanced  disease,  after  discharge  from  the  institution  moved 
their  families  to  Otisville,  and  have  been  able  to  support  them 
in  comfort  there  without  detriment  to  themselves.  The  recital 
of  a  single  case  of  this  sort  will  indicate  the  economic  possibilities 
of  this  procedure : 

About  four  years  ago  a  driver  was  sent  to  the  Sanatorium  at 
Otisville  with  tuberculous  disease  of  the  lungs.  His  family  con- 
sisted of  a  wife  and  nine  children,  of  whom  the  oldest  was  a  girl 
of  twelve  years,  who  also  had  tuberculosis  and  accompanied  her 
father  to  the  Sanatorium.  Two  of  the  younger  children  who  were 
in  poor  physical  condition,  showing  a  positive  tuberculin  reaction, 
were  sent  to  that  admirable  institution,  the  Tuberculosis  Pre- 
ventorium for  Children  at  Farmingdale,  New  Jersey.  The  mother 
and  the  remaining  six  children  were  cared  for  largely  by  the 
Women's  Auxiliary  of  the  Tuberculosis  Clinics  of  the  Department 
of  Health  during  the  father's  stay  in  Otisville.  At  the  end  of  six 
months  his  disease  was  apparently  arrested,  he  had  gained  thirty 
pounds  in  weight,  and  both  he  and  his  daughter,  whose  disease 
was  also  arrested,  returned  to  New  York.  He  presently  found 
occupation  as  a  taxicab  driver,  but  after  a  few  months,  as  a  result 
of  irregular  hours,  exposure,  and  unhygienic  living,  he  commenced 
to  do  badly  and  had  difficulty  in  earning  sufficient  to  maintain  his 

36 


family.  It  was  evident  that  if  he  remained  in  New  York  his 
disease  would  soon  become  again  active,  and  that  the  charitable 
organizations  and  the  city  would  have,  not  only  the  father  and  the 
eldest  daughter  to  care  for  in  tuberculosis  institutions,  but  pos- 
sibly also  some  of  the  younger  children,  and  that  it  would  then 
soon  become  necessary  for  some  one  to  provide  for  the  whole 
family  of  eleven.  I  therefore  determined  to  find  a  home  and 
occupation  for  him  at  Otisville.  A  small  house  was  fitted  up, 
and  a  large  sleeping  porch  and  a  tent  were  provided  where  a 
number  of  the  children  and  the  father  slept.  He  was  given  a 
position  as  watchman  on  the  sanatorium  property  at  fifty  dollars 
a  month.  His  condition  soon  improved,  and  he  now  has  an  ex- 
cellent garden  and  a  small  poultry  plant,  and  is  able  to  entirely 
support  in  comfort  his  whole  family.  The  older  children  attend 
the  district  school.  The  entire  family  is  prosperous,  happy,  and 
contented. 

It  may  safely  be  said  that,  under  ordinary  conditions,  with  the 
almost  certain  return  of  the  disease  in  the  father,  this  family 
would  have  cost  the  community  at  least  twelve  or  fifteen  hundred 
dollars  a  year,  would  have  been  eventually  broken  up,  several  of 
them  would  probably  have  died  from  tuberculosis,  and  a  number 
of  the  children  would  have  been  reared  in  institutions.  A  tu- 
berculosis industrial  colony  would  effectually  deal  with  such 
cases  as  this. 

At  the  last  session  of  the  New  York  State  Legislature  a  bill 
was  passed  at  my  request  authorizing  any  municipahty  maintain- 
ing institutions  for  tuberculosis  to  establish  and  maintain  work- 
shops, for  the  employment  of  persons  who  are  or  have  been  in- 
mates of  such  institutions,  for  the  manufacture  of  articles  and  sup- 
plies to  be  used  in  such  institutions  or  in  other  institutions  con- 
ducted by  the  municipality  or  in  the  departmental  work  of  the 
municipality.  In  other  words,  for  the  manufacture  of  practically 
everything  which  the  municipality  buys  or  uses.  The  products 
of  such  shops  would  not  be  sold  in  open  market,  and  would  not, 
therefore,  come  into  competition  with  other  workers.  In  my  opin- 
ion this  authorization  opens  up  great  possibilities  for  the  solution 

37 


of  this,  the  most  fundamental  factor  in  the  whole  tuberculosis 
problem,  and  without  which  our  elaborate  program  for  the  pre- 
vention of  this  disease  will  fail  of  its  real  purpose.  One  can  readily 
see  that  such  a  plan,  if  it  can  be  successfully  carried  into  effect, 
has  possibiUties  in  the  way  of  municipal  socialism  of  the  first  mag- 
nitude. When  the  New  York  Municipal  Sanatorium  at  Otisville 
is  completed,  it  is  intended  to  provide  for  from  twelve  hundred 
to  fifteen  hundred  patients,  and  as  the  average  residence  in  the 
institution  is  about  six  months,  from  twenty-five  hundred  to 
three  thousand  persons  will  pass  through  it  each  year.  A  large 
proportion  of  the  discharged  cases  are  wiUing  to  remain  and 
should  remain  ill  the  country  for  several  years  or  perhaps  for  a 
lifetime.  The  families  of  many  of  these  patients  would  also  move 
to  the  country,  so  that  the  total  yearly  addition  to  the  colony 
might  equal  or  even  exceed  this  number.  After  a  time  such  a 
colony  would  become  self  contained  and  would  supply  its  own 
needs  of  nearly  every  kind.  It  would  have  cooperative  stores, 
shops,  gardens,  farms,  etc.,  and  might  easily  become  a  town  of 
no  mean  size.  We  hope  in  New  York  city  that  the  financial 
authorities  may  soon  make  provision  for  carrying  this  act  into 
effect.  If  a  solution  of  this  problem  can  thus  be  found,  the  last 
great  obstacle  to  the  success  of  the  tuberculosis  campaign  will 
have  been  removed. 

I  wish  to  briefly  recall  an  incident  which  preceded  the  estab- 
lishment of  the  Henry  Phipps  Institute  in  Philadelphia.  Mr. 
Phipps  had  become  interested  in  tuberculosis  and  its  relief  and 
consulted  several  friends  in  New  York  in  relation  to  the  work 
which  he  had  in  view.  I  did  not,  at  that  time,  have  the  honor 
of  Mr.  Phipps'  acquaintance,  but  was  much  interested  at  the 
prospect  of  a  new  tuberculosis  institution  in  New  York  city.  In 
the  course  of  his  investigations  Mr.  Phipps  came  to  Philadelphia 
and  talked  to  Dr.  Flick,  and  was  soon  so  carried  away  by 
Dr.  Flick's  enthusiasm  that  he  determined  to  establish  this 
work  in  Philadelphia  and  to  place  this  Institute  in  his  charge. 
I  well  remember  our  disappointment  in  New  York  when  we 
learned  that  we  were  to  lose  what  Philadelphia  had  gained.    But 

38 


we  bear  no  envy,  for  the  Phipps  Institute  has  contributed  largely 
to  the  general  advancement  of  the  tuberculosis  movement,  and, 
in  the  larger  sense,  it  little  matters  whether  such  an  institute  is 
located  in  New  York  or  in  Philadelphia  or  in  Baltimore,  which 
latter  city  has  also  received  such  generous  benefactions  from  him. 

This  Institute  occupies  an  extremely  important  and  even 
unique  position  in  the  tuberculosis  campaign.  It  was  not  only 
the  first  scientific  institution  founded  solely  for  the  purpose  of 
assisting  in  the  solution  of  the  tuberculosis  problem,  but  it  is 
still,  so  far  as  I  know,  the  only  institution  or  organization  in  the 
world  which  attempts  to  deal  with  all  phases  of  the  problem. 
It  includes  in  its  scope  the  social  and  economic  features  surround- 
ing the  development  and  existence  of  cases  of  tuberculosis  in  the 
home  and  the  extension  of  relief  there;  the  clinical  aspects  of  the 
disease  with  the  application  of  treatment  to  ambulant  cases, 
and  the  provision  of  institutional  care;  laboratory  investigations 
into  the  etiology,  pathology,  and  specific  treatment  of  the  dis- 
ease; provision  for  training  nurses,  medical  students,  physicians, 
and  research  workers,  in  all  matters  appertaining  to  the  economic, 
scientific,  and  clinical  problems  connected  with  tuberculosis,  and 
finally,  facilities  and  provisions  for  carrying  on  a  general  educa- 
tional propagandum.  It  stands  in  relation  to  the  tuberculosis 
problem  where  the  Rockefeller  Institute  for  Medical  Research 
and  the  Rockefeller  Hospital  stand  in  relation  to  general  medicine, 
with  the  added  social,  economic,  and  educational  features  which 
the  latter  do  not  include. 

I  do  not  know  of  any  medical  or  philanthropic  institution 
which  has  so  comprehensive  a  grasp  of  the  problem  with  which 
it  is  designed  to  deal  as  has  this  institution,  and  when  we  recall 
the  fact  that  this  problem  relates  to  tuberculosis,  which  constitutes 
one  of  the  three  great  factors  which  most  seriously  affect  the 
health,  happiness,  industrial  progress,  and  general  welfare  of  the 
whole  human  race,  we  appreciate  more  fully  the  foresight  and 
wisdom  of  the  founder  and  his  medical  counselor,  Dr.  Lawrence 
Flick,  in  those  earlier  days,  only  a  dozen  years  ago,  when  the 
world-wide  movement  for  the  study  and  prevention  of  this  dis- 

39 


ease  was  but  just  beginning.  Of  Dr.  Flick  and  his  associates 
we  may  well  say  "they  builded  better  than  they  knew."  It 
remains  for  their  successors,  you  who  now  control  the  future 
and  the  destiny  of  this  Institute,  to  determine  fully  the  realiza- 
tion of  their  hopes. 

Most  earnestly  we  extend  today  our  felicitations  and  con- 
gratulations to  the  wise  and  generous  benefactor  of  this  Institute, 
Henry  Phipps,  and  we  may  well  cherish  a  noble  envy  toward 
him,  because  it  was  given  to  him  to  confer  so  great  a  blessing  on 
his  fellow-men. 

I  wish  also  to  extend  our  warm  congratulations  to  the  Uni- 
versity of  Pennsylvania,  which  will  have  in  the  new  buildings  of 
the  Henry  Phipps  Institute  such  unrivaled  opportunities  for  the 
instruction  of  its  students  in  a  most  important  subject,  and  still 
more  I  would  extend  our  hearty  congratulations  to  the  people  of 
Philadelphia,  to  whom  this  Institute  has  been  for  the  past  ten 
years  such  a  benefaction,  because  of  the  larger  opportunities  and 
wider  scope  which  it  will  now  offer;  and,  finally,  I  wish  to  offer 
my  sincere  thanks  to  the  committee  in  charge  of  these  exercises, 
which  has  given  me  the  opportunity  to  express  my  personal 
obligations  to  the  Institute  for  its  work  in  the  past,  in  a  field  which 
to  me  has,  for  more  than  twenty-five  years,  been  one  of  absorbing 
interest. 

The  exercises  closed  with  a  benediction  by  The  Rev.  Dr. 
Tomkins. 


40 


SPEECHES  AT  THE  DINNER 

THE  HOTEL  BELLE VUE-STRATFORD 


Dr.  J.  William  White,  Toastmaster. 


The  Toastmaster  introduced  Hon.  Rudolph  Blankenburg, 
Mayor  of  the  City  of  Philadelphia. 

Mayor  Blankenburg  said  in  part: 

I  am  more  than  delighted  to  be  with  you  and  I  thank  you 
very  much  for  the  compliment  you  have  paid  me.  There  is  one 
thing  we  boast  of  in  Philadelphia  that  I  don't  believe  any  city  in 
this  country  or  the  whole  world  can  boast  of  with  equal  absolute 
propriety,  and  that  is,  our  institutions  to  help  those  in  distress, 
the  sick  and  the  poor,  and  our  educational  institutions.  Now  I 
don't  want  to  make  any  invidious  comparisons,  but  I  am  very 
proud  of  the  University  of  Pennsylvania.  The  Provost  is  here 
and  I  hope  he  will  applaud  that  sentiment.  And  I  am  very 
proud  of  a  great  many  other  of  our  institutions.  I  am  proud  of 
Girard  College:  there  is  nothing  in  the  world  equal  to  it.  Here 
we  have  a  new  institution,  the  Phipps  Institute,  dedicated  to  the 
people  of  Philadelphia,  to  those  suffering  from  tuberculosis,  by  one 
broad-minded,  liberal-spirited  individual,  Mr.  Henry  Phipps.  I  was 
exceedingly  sorry  that  I  could  not  be  at  the  opening  of  the  Insti- 
tute this  afternoon,  but  unfortunately  I  cannot  be  in  more  than  one 
place  at  one  time,  otherwise  I  would  have  been  there  to  enjoy  with 
the  rest  of  you  the  inspection  of  that  really  wonderful  institution. 
This  afternoon  we  dedicated  and  opened  an  Orphans'  Home  built 

41 


by  the  Odd  Fellows;  that's  a  new  institution.  It  is  built  to  help  to 
educate,  to  give  shelter,  and  to  clothe  two  hundred  orphan  boys 
and  orphan  girls  there,  children  of  Odd  Fellows.  Now  it  is  really 
remarkable;  if  anybody  comes  to  Philadelphia  and  wants  to  see 
all  our  educational  institutions, — institutions  like  Girard  College, 
like  the  Phipps  Institute, — it  would  take  him  weeks  and  weeks  to 
go  over  them,  not  to  speak  of  West  Philadelphia — the  Almshouse 
and  the  Municipal  Hospital  and  the  Home  for  the  Indigent  at 
Hohnesburg  and  other  places.  Well,  I  tell  you,  gentlemen.  Dr. 
Neff  is  making  good  and  he  wiU  make  good  there.  That  is  one 
of  the  difficulties  that  we  are  laboring  under  in  Philadelphia. 
If  you  do  good  work,  people  pay  very  little  attention  to  it,  and  if 
a  mistake  is  made,  no  matter  how  sHght  it  may  be,  they  make  a 
mountain  out  of  a  molehill;  that  is  what  Philadelphia  has  been 
suffering  from.  Now,  I  am  a  booster:  I  want  to  boost  Phila- 
delphia in  every  possible  way,  but  I  want  Philadelphia  to  de- 
serve to  be  boosted,  and  there,  gentlemen,  I  appeal  to  you  for 
your  help,  every  one  of  you.  I  don't  know  that  there  is  any  class 
of  citizens  that  can  do  more  in  that  direction  than  the  doctors 
and  educators.  You  enter  home  after  home  every  day  in  the 
week.  You  naturally  become  acquainted  and  become  on  good 
terms  with  your  patients,  the  fathers  and  mothers  and  children; 
and  the  3,000  or  3,500  doctors  in  Philadelphia,  if  they  only  will, 
can  be  made  an  agency  for  good  that  it  has  never  yet  been  known 
it's  possible  for  them  to  be.  Now  I  should  like  very  much  to  have 
you  gentlemen  bear  that  in  mind.  I  am  only  one  poor  individual. 
I  have  a  task  before  me, — I  think  Hercules'  was  simply  kinder- 
garten alongside  of  what  I  have  here  in  Philadelphia,  but  with  the 
aid  of  the  good  citizens  of  Philadelphia, — ^with  the  aid  of  the 
intelligent  citizens  of  Philadelphia,  I  hope  to  be  able  to  assist — 
because  I  can't  do  it  alone — in  making  Philadelphia  the  best 
governed  municipaHty  in  our  country. 

I  have  spoken  to  these  gentlemen  in  my  native  tongue  and  I 
have  said  to  them:  "If  we  can  only  succeed  in  giving  municipal 
government  in  our  country  such  as  they  have  in  England  and 
Germany  and  France  and  other  countries,  the  whole  question 

42 


of  a  republican  form  of  government  will  be  solved,  for  good  gov- 
ernment in  nation  and  in  State  depends  upon  good  municipal 
government."  If  you  will  give  me  good  municipal  government, 
the  question  of  good  State  and  national  government  is  solved; 
and  is  there  one  city  in  this  country  that  should  take  the  first 
step  in  that  direction  sooner  than  the  city  of  Philadelphia?  We 
have  done  more  in  Philadelphia  for  this  great  country  than  any 
other  community  or  any  other  municipahty,  I  don't  even  except 
New  York.  Now,  gentlemen,  here  is  the  plain  proposition  before 
us;  we  can  do  these  things  if  we  will.  Will  we  do  them?  If  you 
will  help  me,  these  things  will  be  accompUshed  and  Philadelphia 
will  stand  as  the  guiding  star  for  all  municipalities  in  our  beloved 
country. 

The  Toastmaster,  proposing  the  health  of  Mr.  Phipps : 
About  fifteen  years  ago,  in  the  middle  of  the  winter,  when  I  was 
on  my  way  to  Palm  Beach,  I  left  the  dining-car  of  the  train  in  a  very 
bad  humor  because  I  had  not  succeeded  in  getting  any  food  that 
was  fit  to  eat.  I  went  into  a  smoking  compartment  and  found  a 
gentleman  there,  the  only  occupant  of  it,  a  gentleman  of  about 
my  own  age,  who  was  just  beginning  a  very  appetizing  looking 
cold  lunch  that  he  had  providently  provided  himself  with.  To 
my  surprise  and  gratification,  he  asked  me  to  join  him,  and  after 
a  period  of  more  or  less  hypocritical  pretense  at  hesitation,  I  did 
so.  My  benefactor  on  that  occasion  was  Mr.  Henry  Phipps,  and 
that  was  my  first  experience  of  his  willingness  to  help  the  poor  and 
unfortunate.  I  have  met  him  since  then  in  many  parts  of  the 
world,  on  the  North  Atlantic,  in  New  York,  in  London,  in  Aber- 
deen, but  wherever  I  have  met  him  and  under  all  circumstances, 
I  found  this  same  willingness  to  help  out  of  his  abundance  any  one 
who  might  chance  or  whom  he  thought  might  chance  to  need  it. 
The  little  incident  with  which  our  acquaintance  began  was  really 
deeply  significant  and  illustrated  one  of  Mr.  Phipps'  most  notable 
characteristics. 

It  is  quite  impossible  adequately  to  express  our  appreciation 
of  the  splendid  charity,  the  latest  development  of  which  has 

43 


brought  us  together  here  this  evening.  We  hope  and  believe, 
all  of  us  who  are  interested  in  it,  that  in  the  good  which  it  will  do, 
in  the  aid  it  will  bring  to  suffering  humanity,  in  the  light  it  will 
cast  on  the  places  where  death  and  disease  lurk,  it  will  be  second 
to  none  of  the  many  magnificent  benefactions  of  Mr.  Phipps. 
The  University  of  Pennsylvania  and  all  of  us  who  are  privileged 
to  share  in  this  work  are  trying,  with  the  unselfish  help  of  the 
noble  men  from  all  over  the  country  who  are  good  enough  to  act 
as  our  Advisory  Council,  to  secure  the  largest  possible  practical 
results  from  the  opportunities  that  Mr.  Phipps  has  given  us.  We 
trust  that  time  may  justify  our  hopefulness,  and  that  the  Phipps 
Institute  will  not  be  the  least  among  the  many  splendid  monu- 
ments that  Mr.  Phipps  has  so  wisely  erected.  He  is  unfortunately 
not  here  tonight  to  listen  to  our  expression  of  appreciation  and 
gratitude,  but  a  number  of  his  immediate  family  are  here  who 
can  convey  to  him  what  we  say  and  think  and  feel,  and  all  that 
we  can  do  now  is  to  drink  the  health  of  Mr.  Henry  Phipps,  as 
I  beg  you  to  rise  and  do. 

The  Toastmaster,  introducing  Dr.  S.  Weir  Mitchell: 
I  have  always  noticed  that  toastmasters  are  apt  to  talk  either 
too  much  or  too  little,  though  I  confess  to  a  very  kindly  feeling 
for  the  latter  class.  They  have,  however,  many  good  excuses. 
Sometimes  they  suffer  for  lack  of  material  for  their  introductions 
which  must,  perforce,  be  laudatory  no  matter  what  their  personal 
opinion  of  the  introducees  may  be.  It  happens,  far  less  fre- 
quently, that  they  are  embarrassed  by  an  excess  of  material;  and 
yet  such  happens  to  be  my  case  this  evening. 

When  one  is  unfortunate  enough  to  have  on  his  hands,  in  the 
person  of  one  individual,  a  distinguished  physician,  an  original 
investigator  in  medicine  and  the  allied  sciences,  a  pioneer  in  the 
non-medicinal  treatment  of  disease,  a  novelist  of  world-wide  repu- 
tation, a  poet  of  distinction,  a  wise  counselor  and  kindly  friend 
of  all  the  youthful  and  struggling,  whether  of  his  profession  or  not, 
a  successful  administrator  of  funds  contributed  by  others  and  a 
liberal  giver  of  his  own,  a  man  who,  in  fact,  if  he  had  also  been  a 

44 


surgeon,  would  have  left  no  heights  unsealed,  it  is  obvious  that 
all  that  remains  to  the  toastmaster  is  to  say, — Dr.  Weir  Mitchell, 
of  Philadelphia  and  the  rest  of  the  universe, — and  sit  down. 

Dr.  Mitchell: 

Mr.  Chairman,  and  you,  Mr.  Phipps,  who  honor  us  with  your 
presence  here:  I  accepted  with  unusual  anxiety  the  invitation  to 
say  something  at  this  dinner.  It  seems  impossible  for  the 
Anglo-Saxon  to  do  anything  on  a  large  scale  without  pledging  a 
certain  number  of  people  to  make  themselves  uncomfortable  with 
the  prospect  of  an  after-dinner  address.  Nor  is  my  task  an  easy 
one,  since  this  is  not  a  time  for  the  usual  post-prandial  jesting. 
The  occasion  is  unique  in  the  history  of  this  city — almost  equally 
so  in  the  history  of  assisted  science;  and  you  may  know,  of  course, 
that  the  splendid  gift  which  we  saw  this  afternoon  and  celebrate 
this  evening  was  indirectly  brought  about  by  the  wonderful  self- 
sacrificing  researches  of  Dr.  Flick,  to  whom  I  am  glad  to  pay 
this  honest  tribute  of  admiring  respect. 

It  is  a  melancholy  fact  that  one  cannot  talk  to  you  after  dinner 
without  using  the  grim  text  tubercle.  There  is  no  escape.  More 
easy  and  more  pleasant  would  it  have  been  to  find  gracious  words 
with  which  to  thank  a  public  benefactor  for  material  aid  to  the 
art  of  medicine  and  the  sciences  on  which  it  is  founded.  I  do  not 
see  why  I  have  been  chosen  as  the  first  speaker  to-night.  So 
far  as  I  am  concerned,  cases  of  tubercle  have,  for  the  most  part, 
disappeared  from  my  medical  horizon,  and  I  naturally  turn  back 
to  memories  not  without  interest.  I  have  lived  through  certain 
phases  of  popular  belief  in  regard  to  consumption,  so  called. 
When  I  was  a  young  man,  nobody  feared  personal  infection  from 
tubercle.  There  came,  then,  a  few  years  ago,  a  time  of  unreason- 
able terror,  which  was  wholesomely  disposed  of  by  so  educating  the 
public  as  to  let  it  understand  what  was  to  be  dreaded  and  how  very 
small  was  the  peril,  provided  certain  precautions  were  taken.  Such 
education  is  still  to  be  a  part  of  the  duties  of  the  Phipps  Hospital. 

In  Latin  countries,  as  you  all  know,  the  behef  in  tubercle 
being  communicable  in  unexplained  ways  was  strongly  held. 

45 


In  1 85 1,  when  in  Rome,  I  wished  to  see  the  room  in  which  the  poet 
Keats  died  of  pulmonary  tubercle.  It  had  become  an  object  of 
interest  to  the  EngHsh  and  Americans,  and  this  had  so  revived 
the  memory  of  his  disease  and  death  that  my  old  Roman  guide 
had  some  disinclination  to  go  into  the  room  where  this  death 
occurred,  although  thirty  years  had  passed,  the  poet  having  died 
in  182 1.  The  circumstances  surrounding  the  death  of  this  gifted 
man  are  interesting  as  evidence  of  the  popular  fear  of  infection  in 
Rome.  The  police,  as  soon  as  possible,  collected  all  of  Keats' 
personal  clothing,  his  bed-clothes,  the  bed  and  all  the  furniture 
of  the  room,  and  burned  them  in  the  Piazza  di  Spagna  in  front  of 
the  house.  The  piano  was  saved  with  difficulty.  Their  pre- 
cautions also  included  whitewashing  and  repainting  the  chamber 
in  which  the  death  took  place.  If  these  radical  measures  were 
carried  out  after  every  death  from  consumption  in  Rome,  it  must, 
of  course,  have  helped  to  deepen  the  feeling  of  terror  with  which 
the  people  regarded  all  tubercular  sufferers. 

We  are  well  informed  of  the  gross  natural  history  of  this 
disease,  but  no  man  will  dare  to  say  that  there  is  as  yet  any  serum 
or  any  drug  that  is  directly  victorious  in  our  battle  with  this 
bitter  foe.  The  costly  mechanism  for  research  which  you  saw 
this  afternoon  is  the  silent  affirmation  of  this  sad  confession. 
The  closed  hands  of  the  future  hold  this  secret.  Now — today — 
the  therapy  of  tubercle  consists  in  hygienic  conditions,  too  well 
known,  too  completely  understood,  to  need  restatement  here; 
and  yet  this  is  all  we  now  know  in  the  way  of  relieving  agencies. 
It  is  not  all  that  nature  knows  today!  In  the  lungs  of  men  who 
have  Hved  hard  lives  in  unwholesome  surroundings,  ill  fed,  are 
found,  after  death,  in  at  least  80  or  90%  of  them,  inert  tubercular 
deposits,  arrested  in  their  growth  no  man  knows  how.  Solve 
that  mystery  of  nature's  therapeutics;  learn  to  imitate  what  acted 
so  beneficially  against  terrible  odds  in  these  cases,  and  you  of  this 
new  Phipps  Hospital  will  have  won  for  it  and  yourselves  immortal 
renown. 

There  have  been  many  generous  endowments  of  hospitals, 
but  the  endowment  on  this  new  plan  of  laboratories  with  a  few 

46 


hospital  beds  for  definite  purposes  of  medical  study  of  the  diseases 
which  have  baffled  us  is  the  last  inspiration  of  the  great  bene- 
factors of  modern  medical  research.  Two  such  institutions  stand 
to  the  credit  of  the  guest  who  honors  us  with  his  presence  tonight. 
What  I  have  longed  for  through  many  disappointing  hours  of 
my  busy  life  is  put  unsolicited  at  the  disposal  of  the  University 
of  Pennsylvania.  I  congratulate  Mr.  Phipps  on  his  large- 
minded  thought  for  the  future  of  men,  who  will  in  the  years  to 
come  profit  by  his  notable  gift. 

And  now,  for  you  of  the  hospital  and  laboratory  staff,  I  have, 
too,  a  word  of  congratulation.  Many  times  in  my  life  I  have 
been  bitterly  defeated  by  the  lack  of  what  has  fallen  lavishly  to 
your  share.  Over  and  over  I  have  wanted  what  you  have  got — 
the  endowment  of  an  opportunity.  You  will  have  learned 
through  the  newspapers  in  any  one  month  that  there  is  no  disease 
on  earth  that  is  not  being  easily  cured;  but  the  thoughtful  medi- 
cal scholar,  the  man  of  experience  in  my  profession,  the  soldier 
of  many  defeats,  knows  well  that  it  is  good  sometimes  to  be  frank 
and  to  confess  that  the  radical  treatment  of  insanity,  of  epilepsy, 
of  cancer,  and,  above  all,  of  tubercle,  is  at  a  standstill.  The 
most  hopeful  of  these  problems  is  yours  to  solve.  Mr.  Phipps 
has  understood  what  was  needed,  and  will  ask  of  you  only  the 
fertile  use  of  his  appreciative  gift. 

And  what  else  is  wanted?  I  asked  lately  a  distinguished 
student  of  physics  how  he  had  won  his  way  to  a  really  great  dis- 
covery. "Oh,"  he  said,  "you  must  have  a  suggestive  mind  and 
listen  to  its  every  whisper.  You  must  live  with  your  problem, 
think  of  it,  dream  of  it,  be  over  and  over  beaten,  but  never  tired 
and  never  routed."  The  first  discovery  every  laboratory  has  to 
make  is  a  man  who  possesses  this  true  scientific  madness,  this 
temperamental,  eager,  unending  curiosity.  The  most  important 
piece  of  mechanism  in  a  laboratory  is  the  hrain  of  a  man. 

Mr.  Phipps'  name  has  been  on  my  lips  two  or  three  times 
casually  during  this  short  address,  but  I  have  not  been  able  any- 
where to  say  fully  what  I  and  other  thoughtful  scientific  students 
of  disease  think  of  the  quality  of  the  gift  he  has  made.    It  is  such 

47 


a  very  uncommonplace  charity!  It  has  so  many  outstretched 
hands  of  giving!  There  is  the  tubercle  class,  the  teaching  of  men 
how  to  live  in  the  slums  and  yet  not  die,  the  helpful  personal  rela- 
tion of  families  who  have  tubercle  among  them,  and  last — not 
least — Oh!  first  of  all — the  outlook  into  a  future  of  research 
glorious  with  hope  and  not  bewildered  in  the  twilight  of  despairing 
therapeutics.  A  day  will  come  when  the  blow  of  the  percussion 
hammer  at  the  top  of  the  lung  and  its  deadly  dull  response  will  be 
an  unimportant  thing,  and  we  shall  be  able  to  say  to  a  man,  here 
at  home  you  shall  get  well  and  not  be  an  exile  condemned  by 
disease  to  flight  and  a  dislocation  of  family  associations  and 
business  relations. 

What  a  mere  yearning  dream  is  that  today!  But  what  is 
life  worth  without  the  splendid  prophecy  of  dreams?  We  have 
conquered  yellow  fever,  are  routing  typhoid,  and  everywhere  our 
therapeutic  hopes  are  brightening.  When  years  ago  Ronald 
Ross  found  at  last  the  zygotes  in  the  stomach  of  the  malaria- 
bearing  mosquito,  he  knew  what  his  seven  years  of  labor  in  the 
heat  of  India  had  won,  and  that  he  had  found  what  up  to  that 
hour  had  been  known  to  God  alone.  Some  day — here,  I  hope, 
in  the  Phipps  laboratory — another  man  will  be  able  to  record  a 
similar  triumph  over  tubercle.  Ah!  then,  well  may  he  quote  those 
lines  which,  throbbing  with  feeling,  Ross  wrote  that  Sunday  of  his 
final  victory  and  of  the  countless  lives  it  would  save: 

"This  day  relenting  God 

Hath  placed  within  my  hand 
A  wondrous  thing;   and  God 
Be  praised.    At  His  command, 

"Seeking  His  secret  deeds 

With  tears  and  toiling  breath 
I  find  thy  cunning  seeds, 
O  million-murdering  Death. 

"I  know  this  little  thing 
A  myriad  men  will  save. 
O  Death,  where  is  thy  sting. 
Thy  victory,  O  Grave!" 
48 


The  Toastmaster,  introducing  Dr.  William  H.  Welch: 
The  purpose  of  our  work,  present  and  projected,  at  the 
Phipps  Institute  is  to  advance  the  sum  of  human  knowledge  re- 
lating to  tuberculosis  on  pathological,  cHnical,  and  sociological 
lines,  and  at  the  same  time  to  educate  as  many  medical  men 
and  medical  students  as  possible  in  the  recognition  and  care 
of  the  disease.  That  is  a  fairly  ambitious  but  a  perfectly  reason- 
able program.  It  would  seem  dijQBcult,  however,  to  find  any  one 
who  could  adequately  represent  all  of  these  diverse  fields  of  effort. 
But  we  are  fortunate  in  having  here  this  evening  the  most  dis- 
tinguished pathologist  of  America,  the  teacher  who  has  probably 
trained  the  largest  number  of  successful  investigators,  the  writer 
who  has  consistently  fostered  and  encouraged  and  contributed 
to  the  science  of  preventive  medicine,  and  the  citizen  who  has  been 
active  in  every  important  movement  in  this  country  to  promote 
the  public  health.  I  have  the  pleasure  of  introducing  to  you 
Dr.  William  H.  Welch,  of  Johns  Hopkins  University. 

Dr.  Welch: 

Mr.  Toastmaster,  Mr.  Phipps,  and  Gentlemen:  Dr.  Mitchell, 
by  his  words  of  singular  charm  and  eloquence,  makes  it  embar- 
rassing for  any  one  to  follow  him.  Nevertheless,  I  should 
regret  not  to  have  the  opportunity  of  bringing  to  the  University 
of  Pennsylvania  and  to  Philadelphia  a  word  of  greeting  and  of 
congratulation  from  that  other  beneficiary  of  the  generosity  of 
Mr.  Phipps.  We  of  Baltimore  and  of  the  Johns  Hopkins 
University  rejoice,  and  rejoice  in  a  very  personal  and  sympa- 
thetic way,  with  the  University  of  Pennsylvania  in  this  large 
opportunity  which  has  come  to  you.  All  who  know  Mr.  Phipps 
know  that  he  is  a  man  whose  heart  is  overflowing  with  kind- 
ness and  with  the  desire  to  benefit  his  fellow-men.  I  have 
never  known  one  more  imbued  with  this  spirit  of  himianity  and 
more  eager  to  find  ways  of  relieving  human  suffering.  It  is,  I 
think,  of  no  little  interest  that  he  has  chosen  particularly  for 
his  generous  gifts  to  medicine  the  support  of  investigations  and 
of  the  care  of  the  two  diseases  which  make  the  strongest  appeal 

49 


to  human  sympathy,  namely,  tuberculosis  and  mental  disorder. 
He  became  interested  in  tuberculosis  largely  through  the  efforts 
of  a  dreamer  to  whom  Dr.  Mitchell  has  referred,  a  man  of  vision, 
a  man  who  early  saw  what  a  great  discovery  meant  for  the  future 
of  mankind.  I  can  recall  my  first  acquaintance  with  Dr.  Flick 
years  before  the  Institute  was  established  through  those  Uttle 
popular  leaflets  which  he  issued,  which  he  sent  to  me.  No  one 
could  read  them  without  feeling  that  here  was  a  man  who  had, 
ahead  of  his  day  and  generation,  a  vision  of  what  it  all  signified 
for  the  future  of  mankind.  His  name  is  one  which  should  always 
be  cherished  in  connection  with  the  history  of  this  important 
institution. 

Dr.  Mitchell  has  referred  to  the  Phipps  Institute  as  offering 
a  great  opportunity,  and  so  it  does.  Its  connection  with  the 
University  of  Pennsylvania  is  of  advantage  to  the  University  and 
it  is  of  advantage  to  the  Institute.  The  service  which  this 
Institute  can  render  to  the  University  is  not  expressed  solely  by 
the  opportunity  for  the  study  of  cases  of  tuberctdosis;  the  pre- 
vention and  cure  of  tuberculosis  have  a  bearing  upon  the  welfare 
of  mankind  far  beyond  what  is  signified  by  the  mere  name  of  the 
disease,  the  reason  being,  as  has  so  often  been  said,  that  the  disease 
is  as  much  a  social  disease  as  it  is  a  mere  physical  ailment,  and 
you  cannot  begin  to  express  the  benefits  to  mankind  merely  in 
terms  of  diminution  in  the  amount  of  tuberculosis. 

There  has  been  no  agency  so  effective  in  stirring  up  the  people 
to  the  importance  of  preventive  medicine  and  of  public  hygiene 
as  that  resulting  from  the  interest  in  the  prevention  and  cure  of 
tuberculosis.  When  you  consider  that  social  conditions  play 
such  a  very  important  part  in  the  causation  of  the  disease,  and 
that  the  eradication  of  tuberculosis  means  an  uplifting  in  living 
conditions,  in  the  social  and  economic  conditions  of  mankind, 
you  can  realize  how  broad  and  significant  is  this  opportunity  to 
which  Dr.  Mitchell  has  referred  and  which  is  rendered  available 
to  this  city  and  to  this  University  by  Mr.  Phipps'  generosity; 
so  the  students  of  the  University  will  learn  not  merely  how  to 
diagnose  tuberculosis  and  the  best  methods  of  treatment,  but 

so 


they  will  be  brought  into  relation  with  most  important  problems 
of  society  and  of  preventive  medicine.  This  Institute  has  already 
done  a  great  service,  as  was  indicated  in  the  interesting  and 
admirable  address  of  Dr.  Flick  this  afternoon.  He  did  not  ex- 
press, I  think,  all  that  is  to  the  credit  of  the  Institute,  but 
the  past,  great  as  it  has  been,  is  only  a  measure,  a  slight  index, 
of  all  the  good  that  will  flow  from  the  establishment  of  this 
Institute.  It  is  almost  unique  in  its  scope.  There  are  sana- 
toria greater  than  the  Phipps  Institute;  there  are  hospitals 
for  the  care  of  advanced  cases  of  tuberculosis  of  more  elaborate 
character  and  larger  than  the  Phipps  Institute;  there  are  dis- 
pensaries for  the  treatment  of  tuberculosis;  there  are  opportuni- 
ties for  social  study  which  are  perhaps  more  elaborate  than 
anything  which  exists  here,  but  there  is  no  other  institute 
which  combines  all  these  directions,  all  these  opportunities,  all 
these  phases  of  the  subject  in  equal  measure,  and  what  is  admir- 
able is  the  lack  of  rigidity  in  the  constitution  of  the  Institute,  its 
elasticity,  its  opportunity  to  adjust  itself  to  new  problems,  to 
be  able  to  lead,  no  matter  in  what  Hne  may  be  the  proposed 
direction  of  advance.  I  conceive,  therefore,  that  the  character  of 
the  Phipps  Institute,  unique  as  I  have  attempted  to  indicate, 
gives  the  most  certain  augury  of  success.  The  debt  which  we 
owe  to  Mr.  Phipps  is  not  a  debt  of  Philadelphia  or  of  the  Uni- 
versity of  Pennsylvania  alone:  it  is  a  debt  of  the  nation,  it  is  a 
debt,  indeed,  of  humanity. 

The  Toastmaster,  introducing  Dr.  Theobold  Smith : 
Closely  allied  to  our  Phipps  Institute  work  is  that  which 
is  being  carried  on  all  over  the  world  by  the  men  who  are 
studying,  investigating,  experimenting  in  relation  to  those 
diseases  of  animals  that  have  an  economic  interest  or  that 
may  affect  the  health  of  the  public  at  large.  Through  the 
laborious  and  skilful  work  of  one  of  these  investigators,  the  sig- 
nificance, the  cause  and  the  mode  of  transmission  of  Texas  cattle 
fever  were  first  demonstrated;  the  distinction  between  the  bacillus 
which  causes  bovine  tuberculosis  and  that  responsible  for  the 

SI 


disease  in  man  was  first  pointed  out;  and  much  light  was  thrown 
on  such  vitally  important  questions  as  intoxication,  auto-intoxi- 
cation, the  mechanism  of  infection,  and  similar  subjects.  It  is 
impossible,  however,  to  mention  more  than  these  few  of  many 
notable  achievements  resulting  from  a  quarter  of  a  century  of 
faithful  and  unremitting  work  by  Dr.  Theobald  Smith,  Professor 
of  Comparative  Pathology  in  Harvard  University,  whom  I  now 
have  the  pleasure  of  introducing  to  you. 

Dr.  Smith: 

Mr.  Toastmaster:  Granted  that  some  of  the  things  you  have 
said  are  true,  you  should  have  known  that  such  a  man  is  not  a 
good  after-dinner  speaker  and  you  should  not  have  chosen  me. 
When  you  asked  me  to  say  a  few  words,  I  did  not  expect  to 
talk  to  such  a  distinguished  assemblage  as  has  been  brought 
together  here  this  evening.  You  have  heard  such  a  wealth 
of  good  speaking  this  afternoon  and  this  evening  that  I  can 
do  very  little  more  than  simply  bring  you  congratulations,  the 
congratulations  of  Harvard  University  and  of  Boston,  sincere 
good  wishes  for  the  development  of  this  great  institution  which  is 
now  going  into  its  second  stage  of  evolution,  the  stage  of  owning 
and  occupying  a  permanent  home.  It  is  difl&cult  to  realize,  unless 
we  spend  our  days  in  the  four  walls  of  a  laboratory,  how  good  it  is 
to  have  a  new  and  well-equipped  home.  I  remember  the  years 
that  I  spent  under  the  attic  roof  of  the  Department  of  Agri- 
culture, working  at  a  difficult  problem.  I  remember  those  years 
as  years  of  great  happiness,  and  yet  I  should  not  wish  that  any 
other  person  should  undergo  the  same  trials  which  I  underwent, 
should  endure  the  heat  of  the  summers  and  the  cold  of  the  winters. 

When  Fliigge,  whom  you  all  know  at  least  by  reputation, 
pubHshed  his  collected  researches  on  the  droplet  infection,  he  was 
met  by  a  colleague  on  the  streets  of  Berlin,  a  colleague  in  medi- 
cine I  believe,  who  said  to  him,  "Why  do  you  get  out  such  a 
large  book  on  tuberculosis?  I  thought  that  question  had  been 
entirely  settled  when  Koch  discovered  the  bacillus."  Now,  we 
have  had  work  done  all  over  the  world  in  tuberculosis  for  the  past 

52 


thirty  years,  and  yet  it  is  difficult  to  go  into  any  assembly  of 
physicians,  of  health  officers,  of  sanitarians,  without  learning 
that  even  the  fundamental  problems  of  tuberculosis  are  not  yet 
understood.    That  was  apparent  in  our  recent  Washington  meet- 
ing.   The  intimate  development  of  the  tubercle  in  the  body  is 
still  a  mystery  to  us.    Undoubtedly,  we  have  done  a  great  many 
things  in  the  past  thirty  years.    We  have  learned  a  great  many 
facts,  but  they  are  fragments — they  are  like  the  stones  of  a  mosaic 
which  we  try  to  put  together  into  a  picture  and  find  that  some  im- 
portant stones  are  missing,  or  even  like  a  picture  puzzle  which  we 
try  to  put  together  and  find  that  we  have  many  pieces,  but  they 
do  not  fit  properly,  and  that  is  the  situation  today  with  refer- 
ence to  the  fundamental  facts  relating  to  tuberculosis.     The 
warfare  between  the  tiny  bacillus  and  the  cells  of  the  body 
which  goes  on  in  what  we  know  as  the  tubercle,  a  thing  that 
is  smaller  than  the  point  of  a  needle,  holds  the  secret  of  the 
struggle  between  man  and  the  tubercle  bacillus.    Why  is  it  that 
sometimes  the  bacillus  is  checked  at  the  very  beginning?    Why 
is  it  that  at  other  times  it  multiplies  without  resistance?   Why  is 
it  that  in  some  individuals  it  can  find  no  foothold  and  cannot 
multiply?    Why  is  it  that  in  others  it  can  multiply  ad  libitum  and 
destroy  life?    These  are  the  questions  which,  it  seems,  we  ought  to 
answer,  but  which  we  are  really  unable  to  answer  at  the  present 
time,  and  here  is  a  great  work  for  the  Henry  Phipps  Institute 
to  do,  and  I  make  a  plea  this  evening  for  the  more  thorough 
theoretical  investigation  of  these  problems.    The  practical  work 
will  surely  be  done;  there  is  plenty  of  stimulus,  plenty  of  pressure 
for  doing  the  immediate  practical  work,  or  at  least  doing  the  work 
which  seems  to  end  in  some  practical  results,  but  the  work  which 
goes  to  the  foundation  of  tuberculosis  is  apt  to  be  put  aside,  it  is 
apt  to  be  crowded  away  when  these  seemingly  more  pressing 
problems  are  presented  to  us.     All  the  important  questions  in 
tuberculosis  look  for  their  answer  to  this  struggle  between  these 
tiny  organisms,  the  cell  of  the  host  and  the  bacillus.     Again,  the 
question  of  environment  in  relation  to  infection  starts  with  the 
evolution  of  the  tubercle.    All  of  you  know  that  the  treatment 

53 


for  tuberculosis  at  the  present  time  is  one  of  environment.  It  is 
a  hygienic  treatment.  We  also  know  that,  owing  to  certain  oc- 
currences, there  are  large  numbers  of  people  in  our  country  today 
who  believe  that  this  long  road  to  recovery  can  be  shortened  by 
some  remedy  which  will  promptly  and  thoroughly  cure  the  disease 
and  release  the  prisoner  from  his  infection.  Now,  is  there  any- 
thing in  our  study  of  tuberculosis  of  the  past  thirty  years  which 
gives  us  the  courage  to  believe  what  the  public  today  is  looking 
for  and  believes?  Some  would  say  that  it  would  be  a  miracle  if 
it  should  come  to  pass  that  tuberculosis  in  its  various  stages  can 
be  cured  by  a  vaccine.  They  would  say  that  it  would  be  like 
converting  the  alchemist's  brass  or  baser  metal  into  gold.  Others, 
perhaps,  would  have  more  hope  and  would  say  that  the  future 
holds  the  possibility  for  such  a  remedy.  This  is  another  great 
problem  for  the  Henry  Phipps  Institute  and  its  workers  to  look 
into  and  to  study  carefully.  The  staff  of  the  Institute  is  not 
biased  by  any  view  which  they  hold  at  present,  which  they  have 
to  maintain,  as  is  the  case  so  often  with  the  institutions  in  Europe 
where  some  pet  theory  of  the  director  is  in  the  foreground  most 
of  the  time.  They  are  free  to  go  ahead  and  to  work  in  any  pos- 
sible direction.  We  should  also  remember  that  although  this 
great  Institution  is  designed  for  the  study  of  one  disease,  what- 
ever discovery  is  made  in  connection  with  that  disease  will  prove 
illuminating  with  reference  to  a  number  of  other  diseases  related 
to  it.  The  Institute  is  not  doing  work  for  one  disease  alone, 
but  is  doing  work  to  reveal  the  causes  and  the  workings  of  a 
group  of  infectious  diseases. 

Now,  there  is  one  word  more  that  I  wish  to  impress  upon  you. 
There  is  at  present  going  on  a  great  movement  among  the  pubhc 
in  the  interest  of  sanitation.  The  people  are  aroused  to  insist 
upon  a  great  many  more  things  for  the  health,  for  the  improve- 
ment of  their  physical  condition,  than  has  ever  been  the  case 
before.  Now,  this  movement,  however  salutary  it  may  be,  may, 
of  course,  also  do  harm.  There  is  a  possibility  that  the  public 
think  that  they  know  more  about  the  subject  of  disease  than  do 
the  experts  who  have  given  their  life  to  investigation,  but  we 

54 


know  that  truths  cannot  be  settled  by  a  show  of  hands,  and  we 
also  know  that  important  questions  and  important  problems  can- 
not be  solved  by  a  referendum  or  a  recall;  this  is  the  work  of 
experts.  Now  the  Phipps  Institute  will  act  as  a  governor  and 
leader  in  this  great  movement  of  the  people.  As  an  institute 
which  has  a  great  deal  of  force  and  momentum,  it  will  be  able 
to  guide  them  into  proper  channels.  It  is  for  the  trustees  to  see 
that  the  men  who  are  there  engaged  to  do  work  are  not  hampered 
by  any  demands  from  the  outside  to  put  to  one  side  the  important, 
thorough,  fundamental  work  which  they  are  doing  for  the  transi- 
tory, superficial  affairs  of  the  day.  It  is  the  business  of  the 
Institute  to  see  that  its  men  go  straight  ahead  with  this  goal  in 
view  that  their  great  object  is  to  release  man  from  the  bondage 
of  the  tubercle  bacillus. 

The  Toastmaster,  introducing  Dr.  Alfred  Stengel: 
If  I  wanted  to  try  to  be  humorous,  I  might  pretend  that  now 
comes  the  strain  on  the  veracity  and  the  imagination  of  the  toast- 
master  that  I  alluded  to  earlier  in  the  evening.  But  that  would 
scarcely  be  fair  to  the  next  and  last  speaker,  who  has  for  years 
been  a  teacher  of  practical  medicine,  an  author  of  success  and 
renown,  a  director  of  a  most  useful  clinical  laboratory,  a  pathologist 
who  has  studied  deeply  and  taught  clearly  the  great  fundamental 
facts  linking  together  the  structural  changes  and  symptoms  caused 
by  disease,  a  former  director  of  a  State  dispensary  for  the  study 
and  treatment  of  tuberculosis,  in  medicine  a  broad-minded  pro- 
gressive— I  can  think  of  no  more  complimentary  term — ^in  civic 
life  ever  identified  with  all  movements  for  the  betterment  of  the 
conditions  under  which  we  live;  let  me  introduce  Prof essor  Alfred 
Stengel,  of  the  Department  of  Medicine  of  the  University  of 
Pennsylvania. 

Dr.  Stengel: 

Mr.  Toastmaster,  Mr,  Phipps,  Gentlemen:  Notwithstanding 
your  toastmaster's  attempt  to  identify  me  with  whatever  polit- 
ical movement  he  himself  may  be  interested  in,  I  shall  accept 

55 


his  designation  as  a  progressive  with  due  humility.  By  the 
accident  of  my  oflScial  position  as  the  head  of  a  Depart- 
ment of  the  University  closely  related  in  its  work  to  the  Insti- 
tute, I  am  called  upon  tonight  to  speak  on  behalf  of  my  colleagues 
of  the  faculty.  In  a  much  broader  sense,  however,  I  feel  that 
my  remarks  should  represent  the  appreciation  of  all  teachers 
of  medicine  that  this  splendid  Institute  has  been  associated  with 
a  medical  school.  I  am  perfectly  certain  that  all  of  us  here 
have  appreciated  the  foresight  of  the  generous  founder  of  this 
Institute,  in  associating  it,  as  well  as  the  tuberculosis  dispensary 
and  the  psychiatric  clinic  of  Johns  Hopkins,  with  universities 
already  well  established  and  equipped  in  other  departments,  and 
I  feel  that  it  is  my  particular  duty  tonight  to  refer  to  this  relation- 
ship of  an  institution  of  this  character  with  a  university  and 
with  a  medical  school,  and  to  allude  somewhat  to  the  reciprocal 
advantages  of  such  a  relationship. 

I  know  that  it  is  unnecessary  for  me  to  speak  at  any  length  now 
of  the  advantages  which  will  accrue  to  the  University  of  Pennsyl- 
vania from  this  association  of  the  Phipps  Institute  with  that 
corporation.  We  all  of  us  here  have  seen  the  magnificent  equip- 
ment and  facilities  which  have  been  placed  at  our  service  there, 
and  we  all  of  us,  I  am  sure,  appreciate  the  care  and  the  thought — 
and  I  want  to  say  particularly  here  the  care  and  the  thought  on 
the  part  of  the  architect  in  the  construction  and  in  the  arrange- 
ment of  that  Institute.  A  splendid  opportunity  and  an  un- 
equaled  equipment  have  been  placed  at  the  disposal  of  the 
University  of  Pennsylvania  for  its  use,  and  we  should  be  singu- 
larly myopic  if  we  failed  to  see  the  advantage  of  these  facilities 
and  failed  to  utilize  them  to  the  uttermost.  The  problem  of 
tuberculosis  is  a  broad  one, — wide  as  himaanity  itself, — and  all 
over  the  world  agencies  of  all  kinds  are  devoted  to  the  attack 
upon  this  dread  disease.  Sanatoria,  hospitals,  laboratories, 
solitary  workers,  social  investigators,  public  officials,  health  de- 
partments— all  these  are  engaged  in  the  combat  against  this 
devastating  disease,  and  in  one  way  or  another  are  contributing 
toward  the  solution  of  the  ultimate  problem,  the  relief  of  suffering 

56 


and  the  cure  of  the  disease.  There  are  three  ways  m  which  insti- 
tutions may  make  an  attack  upon  tuberculosis  or  any  other  disease 
of  this  kind:  first,  the  direct  care  of  the  patient;  second,  educa- 
tion, and  third,  scientific  discovery.  Of  the  direct  value  to  the 
patient  of  such  a  philanthropy  as  this  I  need  say  very  little. 
We  all  have  seen  the  splendid  building  and  the  equipment  that 
is  there.  It  is  impossible  to  doubt  that,  with  this  equipment 
and  with  the  trained  staff  of  physicians  that  will  be  there  engaged, 
it  will  succeed  in  its  purpose  of  relief  to  suffering  mankind  so  far 
as  it  will  be  available  to  patients  in  this  vicinity  or  who  may  come 
to  its  doors.  In  a  striking  way  this  Institute,  as  I  look  at  it 
today,  recalls  to  my  mind  a  commonplace  of  medical  observation, 
that  only  the  very  poor  and  the  very  rich  are  in  a  position  to  enjoy 
the  best  of  medical  attention.  So  far  as  the  care  and  the 
treatment  of  individual  patients  who  apply  here  are  concerned, 
it  matters  very  little  whether  this  Institute  is  associated  with  a 
university  or  a  medical  school  or  not.  The  work  of  the  Institute 
could  doubtless  be  as  well  done  if  it  were  an  independent  organi- 
zation, but  the  extent  of  its  influence  and  usefulness  would  in 
that  case  be  narrow  and  restricted  compared  with  that  which 
will  result  from  its  affiliation  with  a  great  University,  whose 
graduates  go  out  to  all  parts  of  the  world  carrying  with  them 
the  knowledge  they  have  acquired  here,  and  becoming  active 
agents  in  the  dissemination  of  such  knowledge  and,  incidentally, 
speaking  the  fame  of  the  institution  in  which  they  have  received 
their  training.  Those  of  us  here  who  are  familiar  with  the  Uni- 
versity of  Pennsylvania  know  that  her  graduates  are  scattered  all 
over  this  continent  and  in  many  foreign  lands,  and  it  will  be  a  sat- 
isfaction to  us  hereafter  to  know  that  every  one  of  our  graduates 
going  out  in  this  wide  way  to  all  parts  of  the  world  will  carry  with 
them  an  accurate  training  in  modern  investigation  of  this  im- 
portant disease,  and  will  be  disseminators  of  knowledge  and 
probably,  in  their  own  community,  will  establish  institutions  of  a 
similar  character  that  will  further  the  campaign  against  this 
disease.  There  is  no  better  educational  program  that  could  be 
inaugurated  than  this  of  associating  an  institute  of  this  sort  with 

57 


a  medical  school  whose  students  would  get  their  training  within 
its  walls,  and  this,  I  beUeve,  is  the  best  of  reasons  for  the  asso- 
ciation. I  need  not  say  to  any  of  those  who  are  medical  teachers 
that  the  presence  and  the  daily  attendance  of  students  in 
the  institute  will  be  an  active  aiding  cause  for  greater  effort 
on  the  part  of  those  who  are  engaged  in  the  work  here,  and  that, 
if  any  other  reason  were  to  be  thought  of,  this  would  be  the  reason 
for  associating  the  Institute  with  a  medical  school.  In  another 
sense,  the  educational  value  of  this  Institute  will  be  far  reaching; 
I  refer  to  the  publication  of  its  staff,  to  the  lectures  which  they 
will  deliver  within  and  without  its  walls,  to  the  social  service 
work  that  will  be  done  by  those  connected  with  it,  and  to  the  ob- 
ject-lessons which  it  win  bring  to  all  those  who  inspect  it  and  to 
all  those  who  know  of  its  work  and  of  the  results  achieved  here. 
This,  too,  could  be  accompUshed  without  an  association  with  a 
teaching  institution,  but  again  here  we  must  realize  that  the  work 
will  be  better  done,  that  the  staff  will  be  more  earnest  and 
more  eager  in  their  work,  having  students  about  them  in  daily 
attendance. 

The  third  of  the  objects  or  the  purposes  of  such  an  insti- 
tution, that  of  discovery,  is,  after  all,  the  highest  of  all.  Eventu- 
ally it  will  be  given  to  one,  and  if  history  repeats  itself  in  this 
particular,  as  it  has  in  other  matters,  probably  to  two  or  three 
simultaneously,  to  discover  the  cure  for  this  disease.  In  the  mean 
time,  however,  many  workers  in  many  places  in  many  lands  will 
be  engaged  in  studying  out  intermediary  problems,  in  elaborating 
the  steps  toward  the  eventual  solution  of  the  great  problem,  and 
those  who  are  working  here  in  this  Institute  will  find  it  of  ad- 
vantage to  be  associated  with  scientists  engaged  in  other  depart- 
ments of  a  great  university,  and  they  will  receive  encouragement, 
aid,  and  material  advantage  from  this  association  with  others 
in  different  departments  of  the  University.  The  close  relation- 
ship with  these  workers  with  others  in  the  University,  and  the 
association  of  the  Institute  with  the  University,  will  serve  in  a 
way  as  a  check  upon  any  too  enthusiastic  or  too  eager  pronounce- 
ment of  results,  and  at  the  same  time  it  will  be  useful  also  in  sup- 

58 


porting  them  when  results  have  been  achieved  and  publication 
is  ready.  I  foresee,  therefore,  that  the  University  of  Pennsyl- 
vania will  be  able  to  repay  in  some  small  measure  the  debt  which 
it  stands  in  toward  the  Institute,  and  that  in  the  end  we  may 
be  able  to  say  that  we  have  in  some  measure  returned  to  the 
Institute  some  recompense  for  what  it  has  brought  to  us.  I  trust 
and  I  feel  confident  that  the  future  will  justify  us  in  this  hope. 

The  Toastmaster: 

Gentlemen,  I  am  sorry  to  detain  you  now,  even  for  a  moment, 
but  I  don't  think  that  this  gathering  ought  to  disperse  without 
some  expression  on  the  part  of  the  trustees  of  the  University 
of  their  feeling  of  obligation  toward  three  persons.  It  may  seem 
invidious  to  pick  out  only  three  persons  of  the  many  who  have 
been  concerned  in  the  work,  but  I  think  that  it  is  incumbent  upon 
me  to  repeat  and  to  emphasize  the  obhgation  we  feel  ourselves 
under,  first,  to  the  architect,  for  the  magnificent  and  original  way 
in  which  he  has  solved  many  of  the  problems  that  have  been  pre- 
sented to  him  for  the  first  time  in  connection  with  the  establish- 
ment of  this  Institute. 

In  the  next  place,  we  feel  under  similar  obHgations  to  Mr. 
Gordon,  who  has  so  faithfully  represented  Mr.  Phipps,  who  has 
met  us  in  all  our  wishes  and  desires  in  the  most  kindly,  generous, 
and  sympathetic  way;  who  has  come  over  here  from  New  York 
repeatedly  to  watch  over  and  look  after  the  interests  of  the 
Institute,  and  without  whose  aid  we  never  would  have  succeeded 
in  having  the  plant  to  show  you  today  nor  had  the  successful 
opening  that  I  think  I  may  say  we  have  had. 

And,  finally,  I  want  to  mention  our  own  Dr.  Hatfield  who 
has  given  to  this  whole  matter,  and  is  giving  it  daily,  such  a 
degree  of  self-sacrificing,  unselfish,  thoughtful  interest  that  I 
know  he  does  not  leave  himself  sufficient  time  to  give  to  his  own 
affairs.  We  are  all  of  us,  every  trustee  and  every  Philadelphian, 
under  the  deepest  obligations  to  all  three  of  these  gentlemen. 


59 


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